Sample records for mcmaster

  1. A Comparison of the McMaster and Circumplex Family Assessment Instruments.

    ERIC Educational Resources Information Center

    Fristad, Mary A.

    1989-01-01

    Compared clinical rating scales and self-report scales from McMaster and Circumplex models of family functioning with families (N=41). Found McMaster instruments had superior sensitivity; greater correspondence between clinical rating scales and family member self-report inventories on McMaster instruments; and lack of support for the curvilinear…

  2. An Icelandic Version of McMasters Family Assessment Device (FAD)

    ERIC Educational Resources Information Center

    Juliusdottir, Gudlaug M.; Olafsdottir, Hrefna

    2015-01-01

    Purpose: An analysis of the psychometric properties of an Icelandic version of McMasters Family Assessment Device (FAD) was conducted in this study. Method: Two groups, clinical and nonclinical, comprising of 529 parents answered the FAD. The study examined the internal reliability and discriminant validity of the instrument in addition to…

  3. Comparison between McMaster and Mini-FLOTAC methods for the enumeration of Eimeria maxima oocysts in poultry excreta.

    PubMed

    Bortoluzzi, C; Paras, K L; Applegate, T J; Verocai, G G

    2018-04-30

    Monitoring Eimeria shedding has become more important due to the recent restrictions to the use of antibiotics within the poultry industry. Therefore, there is a need for the implementation of more precise and accurate quantitative diagnostic techniques. The objective of this study was to compare the precision and accuracy between the Mini-FLOTAC and the McMaster techniques for quantitative diagnosis of Eimeria maxima oocyst in poultry. Twelve pools of excreta samples of broiler chickens experimentally infected with E. maxima were analyzed for the comparison between Mini-FLOTAC and McMaster technique using, the detection limits (dl) of 23 and 25, respectively. Additionally, six excreta samples were used to compare the precision of different dl (5, 10, 23, and 46) using the Mini-FLOTAC technique. For precision comparisons, five technical replicates of each sample (five replicate slides on one excreta slurry) were read for calculating the mean oocyst per gram of excreta (OPG) count, standard deviation (SD), coefficient of variation (CV), and precision of both aforementioned comparisons. To compare accuracy between the methods (McMaster, and Mini-FLOTAC dl 5 and 23), excreta from uninfected chickens was spiked with 100, 500, 1,000, 5,000, or 10,000 OPG; additional samples remained unspiked (negative control). For each spiking level, three samples were read in triplicate, totaling nine reads per spiking level per technique. Data were transformed using log10 to obtain normality and homogeneity of variances. A significant correlation (R = 0.74; p = 0.006) was observed between the mean OPG of the McMaster dl 25 and the Mini-FLOTAC dl 23. Mean OPG, CV, SD, and precision were not statistically different between the McMaster dl 25 and Mini-FLOTAC dl 23. Despite the absence of statistical difference (p > 0.05), Mini-FLOTAC dl 5 showed a numerically lower SD and CV than Mini-FLOTAC dl 23. The Pearson correlation coefficient revealed significant and positive

  4. Lessons Learned: The McMaster Inquiry Story from Innovation to Institutionalization

    ERIC Educational Resources Information Center

    Cuneo, Carl; Harnish, Del; Roy, Dale; Vajoczki, Susan

    2012-01-01

    There are unique moments in curriculum development when an opportunity for a fresh start or a major turn in design fleetingly presents itself. These moments opened up in different locations across McMaster University at different times and eventually led to several quite different initiatives in inquiry-guided learning (IGL). Well-travelled…

  5. Evaluation of accuracy and precision of a smartphone based automated parasite egg counting system in comparison to the McMaster and Mini-FLOTAC methods.

    PubMed

    Scare, J A; Slusarewicz, P; Noel, M L; Wielgus, K M; Nielsen, M K

    2017-11-30

    Fecal egg counts are emphasized for guiding equine helminth parasite control regimens due to the rise of anthelmintic resistance. This, however, poses further challenges, since egg counting results are prone to issues such as operator dependency, method variability, equipment requirements, and time commitment. The use of image analysis software for performing fecal egg counts is promoted in recent studies to reduce the operator dependency associated with manual counts. In an attempt to remove operator dependency associated with current methods, we developed a diagnostic system that utilizes a smartphone and employs image analysis to generate automated egg counts. The aims of this study were (1) to determine precision of the first smartphone prototype, the modified McMaster and ImageJ; (2) to determine precision, accuracy, sensitivity, and specificity of the second smartphone prototype, the modified McMaster, and Mini-FLOTAC techniques. Repeated counts on fecal samples naturally infected with equine strongyle eggs were performed using each technique to evaluate precision. Triplicate counts on 36 egg count negative samples and 36 samples spiked with strongyle eggs at 5, 50, 500, and 1000 eggs per gram were performed using a second smartphone system prototype, Mini-FLOTAC, and McMaster to determine technique accuracy. Precision across the techniques was evaluated using the coefficient of variation. In regards to the first aim of the study, the McMaster technique performed with significantly less variance than the first smartphone prototype and ImageJ (p<0.0001). The smartphone and ImageJ performed with equal variance. In regards to the second aim of the study, the second smartphone system prototype had significantly better precision than the McMaster (p<0.0001) and Mini-FLOTAC (p<0.0001) methods, and the Mini-FLOTAC was significantly more precise than the McMaster (p=0.0228). Mean accuracies for the Mini-FLOTAC, McMaster, and smartphone system were 64.51%, 21.67%, and

  6. Comparison of McMaster and FECPAKG2 methods for counting nematode eggs in the faeces of alpacas.

    PubMed

    Rashid, Mohammed H; Stevenson, Mark A; Waenga, Shea; Mirams, Greg; Campbell, Angus J D; Vaughan, Jane L; Jabbar, Abdul

    2018-05-02

    This study aimed to compare the FECPAK G2 and the McMaster techniques for counting of gastrointestinal nematode eggs in the faeces of alpacas using two floatation solutions (saturated sodium chloride and sucrose solutions). Faecal eggs counts from both techniques were compared using the Lin's concordance correlation coefficient and Bland and Altman statistics. Results showed moderate to good agreement between the two methods, with better agreement achieved when saturated sugar is used as a floatation fluid, particularly when faecal egg counts are less than 1000 eggs per gram of faeces. To the best of our knowledge this is the first study to assess agreement of measurements between McMaster and FECPAK G2 methods for estimating faecal eggs in South American camelids.

  7. Evolution of student assessment in McMaster University's MD Programme.

    PubMed

    Cunnington, John

    2002-05-01

    In response to the competitive examination culture that pervaded medical education in the 1940s and 1950s the founders of McMaster University's new MD Programme created an assessment system based on group functioning within the tutorial. While the tutorial has served the educational process well, 30 years of experience has highlighted its deficiencies as an assessment tool. This paper describes the accumulation of evidence that led to the awareness of the weakness of tutorial assessment and the attempts to provide reliable assessment by the reintroduction of examinations, but in novel formats which would not alter the goals of the curriculum.

  8. Using the tenets of the problem-centered systems therapy of the family (PCSTF) to teach the McMaster Approach to family therapists.

    PubMed

    Archambault, Richard; Mansfield, Abigail K; Evans, Doug; Keitner, Gabor I

    2014-12-01

    This article describes the videoconferencing training of a group of family therapists in the McMaster Approach to evaluating and treating families. A discussion of the key tenets of the McMaster Approach lays the groundwork for how these tenets were applied to training in a residential treatment agency for adolescents. The article serves as an example of how videoconference technology can facilitate extended training, even from a distance. © 2014 Family Process Institute.

  9. Rural medicine interest groups at McMaster University: a pilot study.

    PubMed

    Blau, Elaine M; Aird, Pamela; Dolovich, Lisa; Burns, Sheri; del Pilar-Chacon, Marie

    2009-01-01

    Although rural medicine interest groups (RMIGs) are prevalent in Canadian medical schools, there is little research on their contribution to rural education, training and careers. We explored 2 broad questions by means of an electronic survey to people who were RMIG participants at McMaster University from 2002 to 2007: 1) What are the experiences of undergraduate trainees in an RMIG? 2) What are the features of RMIGs that contribute to an interest in rural medicine? The survey itself contained 35 questions broken down into sections detailing demographics, involvement in RMIGs, RMIG features, core and elective experiences, careers and Canadian Resident Matching Service. Of the 63 participants who completed the survey, 13 (20.6%) were in postgraduate training and 50 (79.4%) were in undergraduate training. The mean (standard deviation) age of participants was 28.4 (6.5) years and 71.9% percent were female. Respondents indicated that rural placements had the most influence on their choice of specialty and rural interest. Of all the features and activities of the RMIG, rural medicine special events contributed the most to an interest in rural medicine (e.g., "rural medicine days"). At McMaster University, the responses of participants suggested that RMIG participation had more influence on career choice than did the medical school attended. Communities, government organizations, residency programs and others interested in improving access to rural physicians, will note the importance of RMIGs and the importance survey respondents gave to rural medicine special events and rural electives.

  10. Analysis of the accuracy and precision of the McMaster method in detection of the eggs of Toxocara and Trichuris species (Nematoda) in dog faeces.

    PubMed

    Kochanowski, Maciej; Dabrowska, Joanna; Karamon, Jacek; Cencek, Tomasz; Osiński, Zbigniew

    2013-07-01

    The aim of this study was to determine the accuracy and precision of McMaster method with Raynaud's modification in the detection of the eggs of the nematodes Toxocara canis (Werner, 1782) and Trichuris ovis (Abildgaard, 1795) in faeces of dogs. Four variants of McMaster method were used for counting: in one grid, two grids, the whole McMaster chamber and flotation in the tube. One hundred sixty samples were prepared from dog faeces (20 repetitions for each egg quantity) containing 15, 25, 50, 100, 150, 200, 250 and 300 eggs of T. canis and T. ovis in 1 g of faeces. To compare the influence of kind of faeces on the results, samples of dog faeces were enriched at the same levels with the eggs of another nematode, Ascaris suum Goeze, 1782. In addition, 160 samples of pig faeces were prepared and enriched only with A. suum eggs in the same way. The highest limit of detection (the lowest level of eggs that were detected in at least 50% of repetitions) in all McMaster chamber variants were obtained for T. canis eggs (25-250 eggs/g faeces). In the variant with flotation in the tube, the highest limit of detection was obtained for T. ovis eggs (100 eggs/g). The best results of the limit of detection, sensitivity and the lowest coefficients of variation were obtained with the use of the whole McMaster chamber variant. There was no significant impact of properties of faeces on the obtained results. Multiplication factors for the whole chamber were calculated on the basis of the transformed equation of the regression line, illustrating the relationship between the number of detected eggs and that of the eggs added to the'sample. Multiplication factors calculated for T. canis and T. ovis eggs were higher than those expected using McMaster method with Raynaud modification.

  11. The Clinical Librarian and the Patient: Report of a Project at McMaster University Medical Centre.

    ERIC Educational Resources Information Center

    Marshall, Joanne G.; Hamilton, John D.

    In June 1975 a clinical librarian project was initiated in the Gastroenterology Programme of McMaster University Medical Centre (MUMC). The objectives of the project were to assist patients in participating more knowledgeably in their own health care and to assist health professionals in applying the latest information from the biomedical…

  12. Developing the Scholarship of Teaching and Learning at the McMaster Institute for Innovation and Excellence in Teaching and Learning

    ERIC Educational Resources Information Center

    Marquis, Elizabeth; Ahmad, Arshad

    2016-01-01

    This chapter describes three research-informed SoTL initiatives undertaken at the McMaster Institute for Innovation and Excellence in Teaching and Learning and presents preliminary evidence of their impact on teaching, learning, and SoTL.

  13. A Comparison of the Sensitivity and Fecal Egg Counts of the McMaster Egg Counting and Kato-Katz Thick Smear Methods for Soil-Transmitted Helminths

    PubMed Central

    Levecke, Bruno; Behnke, Jerzy M.; Ajjampur, Sitara S. R.; Albonico, Marco; Ame, Shaali M.; Charlier, Johannes; Geiger, Stefan M.; Hoa, Nguyen T. V.; Kamwa Ngassam, Romuald I.; Kotze, Andrew C.; McCarthy, James S.; Montresor, Antonio; Periago, Maria V.; Roy, Sheela; Tchuem Tchuenté, Louis-Albert; Thach, D. T. C.; Vercruysse, Jozef

    2011-01-01

    Background The Kato-Katz thick smear (Kato-Katz) is the diagnostic method recommended for monitoring large-scale treatment programs implemented for the control of soil-transmitted helminths (STH) in public health, yet it is difficult to standardize. A promising alternative is the McMaster egg counting method (McMaster), commonly used in veterinary parasitology, but rarely so for the detection of STH in human stool. Methodology/Principal Findings The Kato-Katz and McMaster methods were compared for the detection of STH in 1,543 subjects resident in five countries across Africa, Asia and South America. The consistency of the performance of both methods in different trials, the validity of the fixed multiplication factor employed in the Kato-Katz method and the accuracy of these methods for estimating ‘true’ drug efficacies were assessed. The Kato-Katz method detected significantly more Ascaris lumbricoides infections (88.1% vs. 75.6%, p<0.001), whereas the difference in sensitivity between the two methods was non-significant for hookworm (78.3% vs. 72.4%) and Trichuris trichiura (82.6% vs. 80.3%). The sensitivity of the methods varied significantly across trials and magnitude of fecal egg counts (FEC). Quantitative comparison revealed a significant correlation (Rs >0.32) in FEC between both methods, and indicated no significant difference in FEC, except for A. lumbricoides, where the Kato-Katz resulted in significantly higher FEC (14,197 eggs per gram of stool (EPG) vs. 5,982 EPG). For the Kato-Katz, the fixed multiplication factor resulted in significantly higher FEC than the multiplication factor adjusted for mass of feces examined for A. lumbricoides (16,538 EPG vs. 15,396 EPG) and T. trichiura (1,490 EPG vs. 1,363 EPG), but not for hookworm. The McMaster provided more accurate efficacy results (absolute difference to ‘true’ drug efficacy: 1.7% vs. 4.5%). Conclusions/Significance The McMaster is an alternative method for monitoring large-scale treatment

  14. McMaster Optimal Aging Portal: an evidence-based database for geriatrics-focused health professionals.

    PubMed

    Barbara, Angela M; Dobbins, Maureen; Brian Haynes, R; Iorio, Alfonso; Lavis, John N; Raina, Parminder; Levinson, Anthony J

    2017-07-11

    The objective of this work was to provide easy access to reliable health information based on good quality research that will help health care professionals to learn what works best for seniors to stay as healthy as possible, manage health conditions and build supportive health systems. This will help meet the demands of our aging population that clinicians provide high quality care for older adults, that public health professionals deliver disease prevention and health promotion strategies across the life span, and that policymakers address the economic and social need to create a robust health system and a healthy society for all ages. The McMaster Optimal Aging Portal's (Portal) professional bibliographic database contains high quality scientific evidence about optimal aging specifically targeted to clinicians, public health professionals and policymakers. The database content comes from three information services: McMaster Premium LiteratUre Service (MacPLUS™), Health Evidence™ and Health Systems Evidence. The Portal is continually updated, freely accessible online, easily searchable, and provides email-based alerts when new records are added. The database is being continually assessed for value, usability and use. A number of improvements are planned, including French language translation of content, increased linkages between related records within the Portal database, and inclusion of additional types of content. While this article focuses on the professional database, the Portal also houses resources for patients, caregivers and the general public, which may also be of interest to geriatric practitioners and researchers.

  15. Modeling the Problem-Based Learning Preferences of McMaster University Undergraduate Medical Students Using a Discrete Choice Conjoint Experiment

    ERIC Educational Resources Information Center

    Cunningham, Charles E.; Deal, Ken; Neville, Alan; Rimas, Heather; Lohfeld, Lynne

    2006-01-01

    Objectives: To use methods from the field of marketing research to involve students in the redesign of McMaster University's small group, problem-based undergraduate medical education program. Methods: We used themes from a focus group conducted in an electronic decision support lab to compose 14 four-level educational attributes. Undergraduate…

  16. Ancylostoma caninum: calibration and comparison of diagnostic accuracy of flotation in tube, McMaster and FLOTAC in faecal samples of dogs.

    PubMed

    Cringoli, Giuseppe; Rinaldi, Laura; Maurelli, Maria Paola; Morgoglione, Maria Elena; Musella, Vincenzo; Utzinger, Jürg

    2011-05-01

    We performed a calibration of flotation in tube, McMaster and FLOTAC to determine the optimal flotation solution (FS) and the influence of faecal preservation for the diagnosis of Ancylostoma caninum in dogs, and compared the accuracy of the three copromicroscopic techniques. Among nine different FS, sodium chloride and sodium nitrate performed best for detection and quantification of A. caninum eggs. Faecal samples, either fresh or preserved in formalin 5%, resulted in higher A. caninum egg counts, compared to frozen samples or preserved in formalin 10% or sodium acetate-acetic acid-formalin. FLOTAC consistently resulted in higher A. caninum eggs per gram of faeces (EPG) and lower coefficient of variation (CV) than McMaster and flotation in tube. The best results in terms of mean faecal egg counts (highest value, i.e. 117.0EPG) and CV (lowest value, i.e. 4.8%) were obtained with FLOTAC using sodium chloride and faecal samples preserved in formalin 5%. Our findings suggest that the FLOTAC technique should be considered for the diagnosis of A. caninum in dogs. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. The bias, accuracy and precision of faecal egg count reduction test results in cattle using McMaster, Cornell-Wisconsin and FLOTAC egg counting methods.

    PubMed

    Levecke, B; Rinaldi, L; Charlier, J; Maurelli, M P; Bosco, A; Vercruysse, J; Cringoli, G

    2012-08-13

    The faecal egg count reduction test (FECRT) is the recommended method to monitor anthelmintic drug efficacy in cattle. There is a large variation in faecal egg count (FEC) methods applied to determine FECRT. However, it remains unclear whether FEC methods with an equal analytic sensitivity, but with different methodologies, result in equal FECRT results. We therefore, compared the bias, accuracy and precision of FECRT results for Cornell-Wisconsin (analytic sensitivity = 1 egg per gram faeces (EPG)), FLOTAC (analytic sensitivity = 1 EPG) and McMaster method (analytic sensitivity = 10 EPG) across four levels of egg excretion (1-49 EPG; 50-149 EPG; 150-299 EPG; 300-600 EPG). Finally, we assessed the sensitivity of the FEC methods to detect a truly reduced efficacy. To this end, two different criteria were used to define reduced efficacy based on FECR, including those described in the WAAVP guidelines (FECRT <95% and lower limit of 95%CI <90%) (Coles et al., 1992) and those proposed by El-Abdellati et al. (2010) (upper limit of 95%CI <95%). There was no significant difference in bias and accuracy of FECRT results across the three methods. FLOTAC provided the most precise FECRT results. Cornell-Wisconsin and McMaster gave similar imprecise results. FECRT were significantly underestimated when baseline FEC were low and drugs were more efficacious. For all FEC methods, precision and accuracy of the FECRT improved as egg excretion increased, this effect was greatest for McMaster and least for Cornell-Wisconsin. The sensitivity of the three methods to detect a truly reduced efficacy was high (>90%). Yet, the sensitivity of McMaster and Cornell-Wisconsin may drop when drugs only show sub-optimal efficacy. Overall, the study indicates that the precision of FECRT is affected by the methodology of FEC, and that the level of egg excretion should be considered in the final interpretation of the FECRT. However, more comprehensive studies are required to provide more insights into

  18. A comparison of modifications of the McMaster method for the enumeration of Ascaris suum eggs in pig faecal samples.

    PubMed

    Pereckiene, A; Kaziūnaite, V; Vysniauskas, A; Petkevicius, S; Malakauskas, A; Sarkūnas, M; Taylor, M A

    2007-10-21

    The comparative efficacies of seven published McMaster method modifications for faecal egg counting were evaluated on pig faecal samples containing Ascaris suum eggs. Comparisons were made as to the number of samples found to be positive by each of the methods, the total egg counts per gram (EPG) of faeces, the variations in EPG obtained in the samples examined, and the ease of use of each of the methods. Each method was evaluated after the examination of 30 samples of faeces. The positive samples were identified by counting A. suum eggs in one, two and three sections of newly designed McMaster chamber. In the present study compared methods were reported by: I-Henriksen and Aagaard [Henriksen, S.A., Aagaard, K.A., 1976. A simple flotation and McMaster method. Nord. Vet. Med. 28, 392-397]; II-Kassai [Kassai, T., 1999. Veterinary Helminthology. Butterworth-Heinemann, Oxford, 260 pp.]; III and IV-Urquhart et al. [Urquhart, G.M., Armour, J., Duncan, J.L., Dunn, A.M., Jennings, F.W., 1996. Veterinary Parasitology, 2nd ed. Blackwell Science Ltd., Oxford, UK, 307 pp.] (centrifugation and non-centrifugation methods); V and VI-Grønvold [Grønvold, J., 1991. Laboratory diagnoses of helminths common routine methods used in Denmark. In: Nansen, P., Grønvold, J., Bjørn, H. (Eds.), Seminars on Parasitic Problems in Farm Animals Related to Fodder Production and Management. The Estonian Academy of Sciences, Tartu, Estonia, pp. 47-48] (salt solution, and salt and glucose solution); VII-Thienpont et al. [Thienpont, D., Rochette, F., Vanparijs, O.F.J., 1986. Diagnosing Helminthiasis by Coprological Examination. Coprological Examination, 2nd ed. Janssen Research Foundation, Beerse, Belgium, 205 pp.]. The number of positive samples by examining single section ranged from 98.9% (method I), to 51.1% (method VII). Only with methods I and II, there was a 100% positivity in two out of three of the chambers examined, and FEC obtained using these methods were significantly (p<0.01) higher

  19. Calibration and diagnostic accuracy of simple flotation, McMaster and FLOTAC for parasite egg counts in sheep.

    PubMed

    Rinaldi, L; Coles, G C; Maurelli, M P; Musella, V; Cringoli, G

    2011-05-11

    The present study was aimed at carrying out a calibration and a comparison of diagnostic accuracy of three faecal egg counts (FEC) techniques, simple flotation, McMaster and FLOTAC, in order to find the best flotation solution (FS) for Dicrocoelium dendriticum, Moniezia expansa and gastrointestinal (GI) strongyle eggs, and to evaluate the influence of faecal preservation methods combined with FS on egg counts. Simple flotation failed to give satisfactory results with any samples. Overall, FLOTAC resulted in similar or higher eggs per gram of faeces (EPG) and lower coefficient of variation (CV) than McMaster. The "gold standard" for D. dendriticum was obtained with FLOTAC when using FS7 (EPG=219, CV=3.9%) and FS8 (EPG=226, CV=5.2%) on fresh faeces. The "gold standard" for M. expansa was obtained with FLOTAC, using FS3 (EPG=122, CV=4.1%) on fresh faeces. The "gold standard" for GI strongyles was obtained with FLOTAC when using FS5 (EPG=320, CV=4%) and FS2 (EPG=298, CV=5%). As regard to faecal preservation methods, formalin 5% and 10% or freezing showed performance similar to fresh faeces for eggs of D. dendriticum and M. expansa. However, these methods of preservation were not as successful with GI strongyle eggs. Vacuum packing with storage at +4°C permitted storage of GI strongyle eggs for up to 21 days prior to counting. Where accurate egg counts are required in ovine samples the optimum method of counting is the use of FLOTAC. In addition, we suggest the use of two solutions that are easy and cheap to purchase and prepare, saturated sodium chloride (FS2) for nematoda and cestoda eggs and saturated zinc sulphate (FS7) for trematoda eggs and nematoda larvae. Copyright © 2010 Elsevier B.V. All rights reserved.

  20. Pooling sheep faecal samples for the assessment of anthelmintic drug efficacy using McMaster and Mini-FLOTAC in gastrointestinal strongyle and Nematodirus infection.

    PubMed

    Kenyon, Fiona; Rinaldi, Laura; McBean, Dave; Pepe, Paola; Bosco, Antonio; Melville, Lynsey; Devin, Leigh; Mitchell, Gillian; Ianniello, Davide; Charlier, Johannes; Vercruysse, Jozef; Cringoli, Giuseppe; Levecke, Bruno

    2016-07-30

    In small ruminants, faecal egg counts (FECs) and reduction in FECs (FECR) are the most common methods for the assessment of intensity of gastrointestinal (GI) nematodes infections and anthelmintic drug efficacy, respectively. The main limitation of these methods is the time and cost to conduct FECs on a representative number of individual animals. A cost-saving alternative would be to examine pooled faecal samples, however little is known regarding whether pooling can give representative results. In the present study, we compared the FECR results obtained by both an individual and a pooled examination strategy across different pool sizes and analytical sensitivity of the FEC techniques. A survey was conducted on 5 sheep farms in Scotland, where anthelmintic resistance is known to be widespread. Lambs were treated with fenbendazole (4 groups), levamisole (3 groups), ivermectin (3 groups) or moxidectin (1 group). For each group, individual faecal samples were collected from 20 animals, at baseline (D0) and 14 days after (D14) anthelmintic administration. Faecal samples were analyzed as pools of 3-5, 6-10, and 14-20 individual samples. Both individual and pooled samples were screened for GI strongyle and Nematodirus eggs using two FEC techniques with three different levels of analytical sensitivity, including Mini-FLOTAC (analytical sensitivity of 10 eggs per gram of faeces (EPG)) and McMaster (analytical sensitivity of 15 or 50 EPG).For both Mini-FLOTAC and McMaster (analytical sensitivity of 15 EPG), there was a perfect agreement in classifying the efficacy of the anthelmintic as 'normal', 'doubtful' or 'reduced' regardless of pool size. When using the McMaster method (analytical sensitivity of 50 EPG) anthelmintic efficacy was often falsely classified as 'normal' or assessment was not possible due to zero FECs at D0, and this became more pronounced when the pool size increased. In conclusion, pooling ovine faecal samples holds promise as a cost-saving and efficient

  1. Respiratory medicine at McMaster University, Hamilton, Ontario: 1968 to 2013

    PubMed Central

    Jones, Norman L; O’Byrne, Paul M

    2014-01-01

    The medical school at McMaster University (Hamilton, Ontario) was conceived in 1965 and admitted the first class in 1969. John Evans became the founding Dean and he invited Moran Campbell to be the first Chairman of the Department of Medicine. Moran Campbell, already a world figure in respiratory medicine and physiology, arrived at McMaster in September 1968, and he invited Norman Jones to be Coordinator of the Respiratory Programme. At that time, Hamilton had a population of 300,000, with two full-time respirologists, Robert Cornett at the Hamilton General Hospital and Michael Newhouse at St Joseph’s Hospital. From the clinical perspective, the aim of the Respiratory Programme was to develop a network approach to clinical problems among the five hospitals in the Hamilton region, with St Joseph’s Hospital serving as a regional referral centre, and each hospital developing its own focus: intensive care and burns units at the Hamilton General Hospital; cancer at the Henderson (later Juravinski) Hospital; tuberculosis and rehabilitation at the Chedoke Hospital; pediatrics and neonatal intensive care at the McMaster University Medical Centre; and community care at the Joseph Brant Hospital in Burlington (Ontario). The network provided an ideal base for a specialty residency program. There was also the need to establish viable research. These objectives were achieved through collaboration, support of hospital administration, and recruitment of clinicians and faculty, mainly from our own trainees and research fellows. By the mid-1970s the respiratory group numbered more than 25; outpatient clinic visits and research had grown beyond our initial expectations. The international impact of the group became reflected in the clinical and basic research endeavours. ASTHMA: Freddy Hargreave and Jerry Dolovich established methods to measure airway responsiveness to histamine and methacholine. Allergen inhalation was shown to increase airway responsiveness for several weeks

  2. [Evaluation of a German version of WOMAC (Western Ontario and McMaster Universities) Arthrosis Index].

    PubMed

    Stucki, G; Meier, D; Stucki, S; Michel, B A; Tyndall, A G; Dick, W; Theiler, R

    1996-01-01

    The WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index is a tested questionnaire to assess symptoms and physical functional disability. We adapted the WOMAC for the German language and tested its metric properties, test-retest reliability and validity in 51 patients with knee and hip OA. All WOMAC scales (pain, stiffness, function) were internally consistent with Cronbach's coefficient alpha ranging from 0.80 to 0.96. Test-retest reliability was satisfactory with intraclass correlation coefficients ranging from 0.55 to 0.74. All scales and the global index calculated as the mean of scale scores had a bimodal distribution and a slight ceiling effect. As hypothesized the WOMAC scales were associated with radiological OA-severity and limitations of range-of-motion. Patients with more severe symptoms and functional disability perceived more limitations in their roles at home and at work. The presented German version of the WOMAC is a reliable and valid instrument for the assessment of symptoms and physical functional disability in patients with knee and hip OA.

  3. Hip disability and osteoarthritis outcome score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index.

    PubMed

    Klässbo, Maria; Larsson, Eva; Mannevik, Eva

    2003-01-01

    To further develop the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC LK 3.0) for people with hip disability with or without hip osteoarthritis (OA), 52 subjects (median age 64 yrs, 35 women) answered a version of the Index with additional dimensions, twice, with a one-week interval. Reproducibility, percentage of zero scores (best possible scores), mean score of symptoms, and importance, were analyzed. This resulted in the Hip disability and osteoarthritis outcome score (HOOS LK 1.1), a 39-item questionnaire with five separate sub-scales. There were higher median scores (more symptoms) for three of HOOS sub-scales Pain, Activity limitations--sport and recreation, and Hip-related Quality of life compared to those in the WOMAC, improving the ability to assess change in patients over time. The HOOS appears to be an evaluative instrument for assessing important self-rated hip problems for people with hip disability with/without hip OA, but additional studies are needed.

  4. The comparison of family function based on the McMaster model in fertile and infertile women

    PubMed Central

    Zanganeh, B; Kaboudi, M; Ashtarian, H; Kaboudi, B

    2015-01-01

    Introduction: One of the main parts of the lives of infertile impaired is social relationships and their family functions. This study aimed to compare the family function based on the McMaster model in fertile and infertile women. Materials and Methods: This research is a similar one. The population consisted of all infertile women referred to the two infertility centers and fertile females related to health areas located in the same area in Tehran. The sampling method was the convenience one and in both groups, 50 women were recruited as samples and they responded to the demographic and Family Assessment Device (FAD) questionnaires. The obtained information was investigated by using inferential and descriptive statistics and SPSS 22 software. Findings: The results showed the following behavioral control variables (p = 0/ 003), roles (p = 0/ 002), emotional responsiveness (p = 0/ 020) and emotional involvement (p = 0/ 006). There was a clear distinction between fertile and infertile women and infertile women obtained worse scores. Conclusion: The results indicated that infertile women have crucial problems in family functioning that can have an impact on other aspects of life and their health. PMID:28316731

  5. Reliability and validity of a short version of the general functioning subscale of the McMaster Family Assessment Device.

    PubMed

    Boterhoven de Haan, Katrina L; Hafekost, Jennifer; Lawrence, David; Sawyer, Michael G; Zubrick, Stephen R

    2015-03-01

    The General Functioning 12-item subscale (GF12) of The McMaster Family Assessment Device (FAD) has been validated as a single index measure to assess family functioning. This study reports on the reliability and validity of using only the six positive items from the General Functioning subscale (GF6+). Existing data from two Western Australian studies, the Raine Study (RS) and the Western Australian Child Health Survey (WACHS), was used to analyze the psychometric properties of the GF6+ subscale. The results demonstrated that the GF6+ subscale had virtually equivalent psychometric properties and was able to identify almost all of the same families who had healthy or unhealthy levels of functioning as the full GF12 subscale. In consideration of the constraints faced by large-scale population-based surveys, the findings of this study support the use of a GF6+ subscale from the FAD, as a quick and effective tool to assess the overall functioning of families. © 2014 Family Process Institute.

  6. User Experiences of the McMaster Optimal Aging Portal’s Evidence Summaries and Blog Posts: Usability Study

    PubMed Central

    M Barbara, Angela; Dobbins, Maureen; Haynes, R Brian; Iorio, Alfonso; Lavis, John N

    2016-01-01

    Background Evidence summaries and blogs can support evidence-informed healthy aging, by presenting high-quality health research evidence in plain language for a nonprofessional (citizen) audience. Objective Our objective was to explore citizens’ perceptions about the usability of evidence summaries and blog posts on the Web-based McMaster Optimal Aging Portal. Methods Twenty-two citizens (aged 50 years and older) and informal caregivers participated in a qualitative study using a think-aloud method and semistructured interviews. Eleven interviews were conducted in person, 7 over the telephone, and 4 by Skype. Results We identified themes that fell under 4 user-experience categories: (1) desirability: personal relevance, (2) understandability: language comprehension, grasping the message, dealing with uncertainty, (3) usability: volume of information, use of numbers, and (4) usefulness: intention to use, facility for sharing. Conclusions Participants recognized that high-quality evidence on aging was valuable. Their intended use of the information was influenced by how much it applied to their own health circumstances or those of a loved one. Some specific formatting features that were preferred included consistent layout, content organized by subheadings, catchy titles, numerical information summarized in a table, and inclusion of a glossary. PMID:27542995

  7. Can the pre-operative Western Ontario and McMaster score predict patient satisfaction following total hip arthroplasty?

    PubMed

    Rogers, B A; Alolabi, B; Carrothers, A D; Kreder, H J; Jenkinson, R J

    2015-02-01

    In this study we evaluated whether pre-operative Western Ontario and McMaster Universities (WOMAC) osteoarthritis scores can predict satisfaction following total hip arthroplasty (THA). Prospective data for a cohort of patients undergoing THA from two large academic centres were collected, and pre-operative and one-year post-operative WOMAC scores and a 25-point satisfaction questionnaire were obtained for 446 patients. Satisfaction scores were dichotomised into either improvement or deterioration. Scatter plots and Spearman's rank correlation coefficient were used to describe the association between pre-operative WOMAC and one-year post-operative WOMAC scores and patient satisfaction. Satisfaction was compared using receiver operating characteristic (ROC) analysis against pre-operative, post-operative and δ WOMAC scores. We found no relationship between pre-operative WOMAC scores and one-year post-operative WOMAC or satisfaction scores, with Spearman's rank correlation coefficients of 0.16 and -0.05, respectively. The ROC analysis showed areas under the curve (AUC) of 0.54 (pre-operative WOMAC), 0.67 (post-operative WOMAC) and 0.43 (δ WOMAC), respectively, for an improvement in satisfaction. We conclude that the pre-operative WOMAC score does not predict the post-operative WOMAC score or patient satisfaction after THA, and that WOMAC scores can therefore not be used to prioritise patient care. ©2015 The British Editorial Society of Bone & Joint Surgery.

  8. Attitudes toward the use of gender-inclusive language among residency trainees. The McMaster Residency Training Program Directors.

    PubMed

    Guyatt, G H; Cook, D J; Griffith, L; Walter, S D; Risdon, C; Liutkus, J

    1997-05-01

    To explore postgraduate medical trainees' attitudes toward the use of gender-inclusive language. Self-administered questionnaire. Seven residency training programs at McMaster University, Hamilton, Ont., from July 1993 to June 1994. Of 225 residents in the programs, 186 responded to the survey, for a response rate of 82.7%. Men and women were equally represented among the respondents. Categorization of attitudes about the use of language as gender-inclusive or gender-exclusive; characteristics predicting a gender-inclusive attitude. Factor analysis and Cronbach's alpha (0.90) supported the existence of a construct related to attitudes about language use, the poles of which were categorized as gender-inclusive and gender-exclusive. The authors classified residents with respect to their attitudes to language use from their responses to the questionnaire. In univariate analyses, sex, residency program and country of graduation significantly predicted a gender-inclusive attitude (p < 0.01). Only the first 2 variables were significant in a multivariate model; residency program explained 18% of the variance and sex 3%. Residents in obstetrics and gynecology and psychiatry had the most gender-inclusive attitudes, whereas residents in surgery and anesthesia had the most gender-exclusive attitudes. Residents' values are reflected in the language they choose to use. Language use may provide an index of underlying attitudes that may create hostile environments for female trainees.

  9. Gastrointestinal parasites of cats in Denmark assessed by necropsy and concentration McMaster technique.

    PubMed

    Takeuchi-Storm, N; Mejer, H; Al-Sabi, M N S; Olsen, C S; Thamsborg, S M; Enemark, H L

    2015-12-15

    The large population of feral cats in Denmark may potentially transmit pathogens to household cats and zoonotic parasites to humans. A total of 99 euthanized cats; feral cats (n=92) and household cats with outdoor access (n=7), were collected from March to May 2014 from the Zealand region, Denmark. The sedimentation and counting technique (SCT) was used to isolate helminths and coproscopy was done by concentration McMaster technique (c-McMaster). Overall, 90.1% of the cats were infected and a total of 10 species were recorded by SCT: 5 nematode species: Toxocara cati (84.8%), Ollulanus tricuspis (13.1%), Aonchotheca putorii (7.1%), Paersonema spp. (3.0%), Strongyloides spp. (1.0%); 3 cestodes: Hydatigera taeniaeformis (36.4%), Mesocestoides sp. (3.0%), Dipylidium caninum (1.0%); and 2 trematodes: Cryptocotyle spp. (5.1%) and Pseudamphistomum truncatum (1.0%). O. tricuspis was the second most common gastrointestinal nematode of cats but had the highest intensity of infection. For T. cati, prevalence and worm burden were significantly higher in feral than household cats. No juvenile cats were infected with H. taeniaeformis, and age thus had a significant effect on prevalence and worm burdens of this species. Rural cats had a higher prevalence and worm burden of A. putorii than urban cats. By c-McMaster, ascarid, capillarid, strongylid or taeniid type eggs were found in 77.9% of the cats while Cystoisospora felis was found in 2.1%. The sensitivity of the c-McMaster was 82.5% for T. cati but 26.5% for taeniid eggs, using the SCT as gold standard. A positive correlation between faecal egg counts and worm burdens was seen for T. cati, but not for taeniid eggs (assumed to be H. taeniaeformis). Coprological examination also detected the eggs of extraintestinal Capillariidae species including Eucoleus aerophilus and Eucoleus boehmi, but further necropsy studies are needed to confirm these findings. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Misdiagnosis of primary immune thrombocytopenia and frequency of bleeding: lessons from the McMaster ITP Registry

    PubMed Central

    Nazy, Ishac; Clare, Rumi; Jaffer, Anushka M.; Aubie, Brandon; Li, Na; Kelton, John G.

    2017-01-01

    Nonspecific diagnostic criteria and uncertain estimates of severe bleeding events are fundamental gaps in knowledge of primary immune thrombocytopenia (ITP). To address these issues, we created the McMaster ITP Registry. In this report, we describe the methodology of the registry, the process for arriving at the diagnosis, and the frequency of bleeding. Consecutive patients with platelets <150 × 109/L from a tertiary hematology clinic in Canada were eligible. Patients completed a panel of investigations and were managed per clinical need. Two hematologists initially determined the cause of the thrombocytopenia using standard criteria and reevaluated the diagnosis over time, which was adjudicated at regular team meetings. Bleeding was graded from 0 (none) to 2 (severe) prospectively using an ITP-specific tool. Data were validated by duplicate chart review and source verification. Between 2010 and 2016, 614 patients were enrolled. Median follow-up for patients with >1 visit was 1.7 years (interquartile range, 0.8-3.4). At registration, 295 patients were initially diagnosed with primary ITP; of those, 36 (12.2%) were reclassified as having a different diagnosis during follow-up. At registration, 319 patients were initially diagnosed with another thrombocytopenic condition; of those, 10 (3.1%) were ultimately reclassified as having primary ITP. Of 269 patients with a final diagnosis of primary ITP, 56.5% (95% confidence interval [CI], 50.4-62.5] experienced grade 2 bleeding at 1 or more anatomical site, and 2.2% (95% CI, 0.8-4.8) had intracranial hemorrhage. Nearly 1 in 7 patients with primary ITP were misdiagnosed. Grade 2 bleeding was common. Registry data can help improve the clinical and laboratory classification of patients with ITP. PMID:29296891

  11. The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website.

    PubMed

    Barbara, Angela M; Dobbins, Maureen; Haynes, R Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder; Levinson, Anthony J

    2016-05-11

    Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages). Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes. Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes. A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal's strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features. The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be applied by designers of health-related websites.

  12. The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website

    PubMed Central

    Dobbins, Maureen; Haynes, R. Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder

    2016-01-01

    Background Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages). Objective Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes. Methods Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes. Results A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal’s strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features. Conclusions The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be

  13. Comparison of Kato-Katz thick-smear and McMaster egg counting method for the assessment of drug efficacy against soil-transmitted helminthiasis in school children in Jimma Town, Ethiopia.

    PubMed

    Bekana, Teshome; Mekonnen, Zeleke; Zeynudin, Ahmed; Ayana, Mio; Getachew, Mestawet; Vercruysse, Jozef; Levecke, Bruno

    2015-10-01

    There is a paucity of studies that compare efficacy of drugs obtained by different diagnostic methods. We compared the efficacy of a single oral dose albendazole (400 mg), measured as egg reduction rate, against soil-transmitted helminth infections in 210 school children (Jimma Town, Ethiopia) using both Kato-Katz thick smear and McMaster egg counting method. Our results indicate that differences in sensitivity and faecal egg counts did not imply a significant difference in egg reduction rate estimates. The choice of a diagnostic method to assess drug efficacy should not be based on sensitivity and faecal egg counts only. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Freezing of sheep faeces invalidates Haemonchus contortus faecal egg counts by the McMaster technique.

    PubMed

    Van Wyk, J A; Van Wyk, Laetitia

    2002-12-01

    Faecal pellets from a sheep that was artificially infected with a monoculture of Haemonchus contortus were collected over a 2-h period in the morning. In the laboratory the faeces were thoroughly mixed by hand and 48 by 1 g aliquots of the pellets were sealed in plastic bags, from which the air had gently been expressed. The faecal worm egg count of the sheep was about 14,000 g(-1). Varying numbers of the bags were either processed for faecal worm egg counting (FEC) by the McMaster technique on day 0, or were stored at one of the following temperatures: about 4 degrees C, -10 degrees C or -170 degrees C before processing. The faecal aliquots that were frozen were thawed at room temperature after having been frozen for either 2 h or 7 days, and processing of aliquots maintained at 4 degrees C proceeded shortly after the samples had been removed from the refrigerator. A dramatic reduction in egg numbers was found in all the aliquots that were frozen at -170 degrees C before faecal worm egg counts were done, as well as in those frozen for 7 days at about -10 degrees C. Numerous empty, or partially empty, egg shells were observed when performing the counts in faeces that had been frozen. In contrast, there was no significant reduction in the numbers of eggs in aliquots maintained for 7 days in a refrigerator at +/- 4 degrees C before examination, when compared with others examined shortly after collection of the faeces. Since H. contortus eggs in faeces are damaged by freezing, some methods that can be used for short term preservation are outlined. It is concluded that all nematode egg counts from cryopreserved faeces (whether in a freezer at -10 degrees C or in liquid nitrogen) should possibly be regarded as being inaccurate, unless the contrary can be demonstrated for different worm genera. However, exceptions are expected for the more rugged ova, such as those of the ascarids and Trichuris spp.

  15. Translation and validation of Moroccan Western Ontario and McMaster Universities (WOMAC) osteoarthritis index in knee osteoarthritis.

    PubMed

    Faik, A; Benbouazza, K; Amine, B; Maaroufi, H; Bahiri, R; Lazrak, N; Aboukal, R; Hajjaj-Hassouni, N

    2008-05-01

    The aim of this study is to assess the reliability and validity of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) in Moroccan patients with knee osteoarthritis. The WOMAC was translated and back translated to and from dialectal Arabic, pre-tested and reviewed by a committee following the Guillemin criteria. The Moroccan version of the WOMAC was administered twice during a 24-48 h interval to 71 Moroccan patients with symptomatic knee osteoarthritis, fulfilling the revised criteria of the American College of Rheumatology. The test-retest reliability was assessed using intra-class correlation coefficient, and the Bland and Altman method. Internal consistency was assessed by Cronbach's alpha coefficient. Construct validity was tested by correlating the WOMAC subscales with visual analogic scale (VAS) of pain, VAS of handicap, maximum distance walked and clinical characteristics. The Moroccan version of the WOMAC showed good reliability, with ICC values of the three dimensions: pain, stiffness and physical function being 0.80, 0.77 and 0.89, respectively. Bland and Altman analysis showed that means of differences did not differ significantly from 0 and that no systematic trend was observed. Internal consistency with Cronbach's alpha for pain was found to be 0.76, and its equivalents for stiffness and physical function subscales were evaluated at 0.76, 0.90, respectively. Construct validity showed statistically significant correlation with all WOMAC subscales and VAS of pain (rho=0.38, 0.42, 0.63 respectively, P<0.01). Correlation between VAS handicap (rho=0.38 P<0.001) and maximum distance walked (rho=-0.40, P<0.01) was observed with physical function subscale. There was no correlation between age, duration of disease, BMI and severity of pain and physical function in knee OA. The Moroccan version of the WOMAC is a comprehensible, reliable, and valid instrument to measure outcome in patients with knee OA.

  16. Learning about the Earth through Societally-relevant Interdisciplinary Research Projects: the Honours Integrated Science Program at McMaster

    NASA Astrophysics Data System (ADS)

    Eyles, C.; Symons, S. L.; Harvey, C. T.

    2016-12-01

    Students in the Honours Integrated Science (iSci) program at McMaster University (Hamilton, Ontario, Canada) learn about the Earth through interdisciplinary research projects that focus on important societal issues. The iSci program is a new and innovative undergraduate program that emphasizes the links between scientific disciplines and focuses on learning through research and the development of scientific communication skills. The program accepts up to 60 students each year and is taught by a team of 18 instructors comprising senior and junior faculty, post-doctoral fellows, a lab coordinator, instructional assistant, a librarian and library staff, and an administrator. The program is designed around a pedagogical model that emphasizes hands-on learning through interdisciplinary research (Research-based Integrated Education: RIE) and is mostly project-based and experiential. In their freshman year students learn fundamental Earth science concepts (in conjunction with chemistry, physics, mathematics and biology) through research projects focused on environmental contamination, interplanetary exploration, the effect of drugs on the human body and environment, sustainable energy, and cancer. In subsequent years they conduct research on topics such as the History of the Earth, Thermodynamics, Plant-Animal Interactions, Wine Science, Forensics, and Climate Change. The iSci program attracts students with a broad interest in science and has been particularly effective in directing high quality students into the Earth sciences as they are introduced to the discipline in their first year of study through research projects that are interesting and stimulating. The structure of the iSci program encourages consideration of geoscientific applications in a broad range of societally relevant research projects; these projects are reviewed and modified each year to ensure their currency and ability to meet program learning objectives.

  17. Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

    PubMed

    Cook, D J; Liutkus, J F; Risdon, C L; Griffith, L E; Guyatt, G H; Walter, S D

    1996-06-01

    To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. Self-administered questionnaire. McMaster University, Hamilton, Ont. Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p < 0.01). Ten respondents, all female, reported having experienced discrimination on the basis of their sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p < 0.01), reported experiencing offensive body language and receiving sexist teaching material and unwanted compliments on their dress. Significantly more female respondents than male respondents stated that they had reported events of sexual harassment to someone (p < 0.001). The most frequent emotional reactions to sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20

  18. Association Between the Single Assessment Numeric Evaluation and the Western Ontario and McMaster Universities Osteoarthritis Index

    PubMed Central

    Luc, Brittney A.; Duncan, Austin; Saliba, Susan A.; Hart, Joseph M.; Ingersoll, Christopher D.

    2017-01-01

    Context:  Patient-reported outcomes (PROs) evaluate how patients describe symptoms as well as level of physical function or quality of life. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index is one of the most common PROs used to assess disability in patients with knee osteoarthritis (OA), yet the Single Assessment Numeric Evaluation (SANE) is a single-question instrument that may improve the efficiency associated with the measurement of patient function. Objective:  To determine the associations between (1) SANEFunction and the physical dysfunction subsection of the WOMAC index (WOMACDysfunction) before rehabilitation and after a 4-week therapeutic exercise intervention as well as (2) the percentage change in SANEFunction and WOMACDysfunction in people with knee OA after 4 weeks of therapeutic exercise. Design:  Cross-sectional study. Setting:  Research laboratory. Patients or Other Participants:  Thirty-six participants (15 men, 21 women) with radiographic knee OA. Intervention(s):  Participants completed 12 sessions (over a 4-week period) of therapeutic exercise to strengthen the lower extremity. Main Outcome Measure(s):  The SANEFunction and WOMACDysfunction (WOMACDysfunction normalized to 100%) scores were collected before and after the 4-week intervention. Percentage change scores over the 4-week intervention were calculated for both measures. Results:  Participants with a higher SANEFunction score demonstrated a lower WOMACDysfunction score at baseline (rs = –0.44, P = .007) and at the 4-week time point (rs = –0.69, P < .001). There was a nonsignificant and weak association between the changes in the SANEFunction and WOMACDysfunction scores over the 4 weeks of therapeutic exercise (rs = –0.17, P < .43). Conclusions:  The SANEFunction and WOMACDysfunction scores demonstrated moderate to weak associations before and after a 4-week exercise program, respectively, whereas the changes in SANEFunction and

  19. Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

    PubMed Central

    Cook, D J; Liutkus, J F; Risdon, C L; Griffith, L E; Guyatt, G H; Walter, S D

    1996-01-01

    OBJECTIVE: To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. DESIGN: Self-administered questionnaire. SETTING: McMaster University, Hamilton, Ont. PARTICIPANTS: Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. OUTCOME MEASURES: Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. RESULTS: Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p < 0.01). Ten respondents, all female, reported having experienced discrimination on the basis of their sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p < 0.01), reported experiencing offensive body language and receiving sexist teaching material and unwanted compliments on their dress. Significantly more female respondents than male respondents stated that they had reported events of sexual harassment to someone (p < 0.001). The most frequent emotional reactions to sexual harassment were

  20. Association Between the Single Assessment Numeric Evaluation and the Western Ontario and McMaster Universities Osteoarthritis Index.

    PubMed

    Pietrosimone, Brian; Luc, Brittney A; Duncan, Austin; Saliba, Susan A; Hart, Joseph M; Ingersoll, Christopher D

    2017-06-02

      Patient-reported outcomes (PROs) evaluate how patients describe symptoms as well as level of physical function or quality of life. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index is one of the most common PROs used to assess disability in patients with knee osteoarthritis (OA), yet the Single Assessment Numeric Evaluation (SANE) is a single-question instrument that may improve the efficiency associated with the measurement of patient function.   To determine the associations between (1) SANE Function and the physical dysfunction subsection of the WOMAC index (WOMAC Dysfunction ) before rehabilitation and after a 4-week therapeutic exercise intervention as well as (2) the percentage change in SANE Function and WOMAC Dysfunction in people with knee OA after 4 weeks of therapeutic exercise.   Cross-sectional study.   Research laboratory.   Thirty-six participants (15 men, 21 women) with radiographic knee OA.   Participants completed 12 sessions (over a 4-week period) of therapeutic exercise to strengthen the lower extremity.   The SANE Function and WOMAC Dysfunction (WOMAC Dysfunction normalized to 100%) scores were collected before and after the 4-week intervention. Percentage change scores over the 4-week intervention were calculated for both measures.   Participants with a higher SANE Function score demonstrated a lower WOMAC Dysfunction score at baseline (r s = -0.44, P = .007) and at the 4-week time point (r s = -0.69, P < .001). There was a nonsignificant and weak association between the changes in the SANE Function and WOMAC Dysfunction scores over the 4 weeks of therapeutic exercise (r s = -0.17, P < .43).   The SANE Function and WOMAC Dysfunction scores demonstrated moderate to weak associations before and after a 4-week exercise program, respectively, whereas the changes in SANE Function and WOMAC Dysfunction scores were not associated. These PROs may be measuring different aspects of self-reported function and

  1. McMaster PLUS: a cluster randomized clinical trial of an intervention to accelerate clinical use of evidence-based information from digital libraries.

    PubMed

    Haynes, R Brian; Holland, Jennifer; Cotoi, Chris; McKinlay, R James; Wilczynski, Nancy L; Walters, Leslie A; Jedras, Dawn; Parrish, Rick; McKibbon, K Ann; Garg, Amit; Walter, Stephen D

    2006-01-01

    Physicians have difficulty keeping up with new evidence from medical research. We developed the McMaster Premium LiteratUre Service (PLUS), an internet-based addition to an existing digital library, which delivered quality- and relevance-rated medical literature to physicians, matched to their clinical disciplines. We evaluated PLUS in a cluster-randomized trial of 203 participating physicians in Northern Ontario, comparing a Full-Serve version (that included alerts to new articles and a cumulative database of alerts) with a Self-Serve version (that included a passive guide to evidence-based literature). Utilization of the service was the primary trial end-point. Mean logins to the library rose by 0.77 logins/month/user (95% CI 0.43, 1.11) in the Full-Serve group compared with the Self-Serve group. The proportion of Full-Serve participants who utilized the service during each month of the study period showed a sustained increase during the intervention period, with a relative increase of 57% (95% CI 12, 123) compared with the Self-Serve group. There were no differences in these proportions during the baseline period, and following the crossover of the Self-Serve group to Full-Serve, the Self-Serve group's usage became indistinguishable from that of the Full-Serve group (relative difference 4.4 (95% CI -23.7, 43.0). Also during the intervention and crossover periods, measures of self-reported usefulness did not show a difference between the 2 groups. A quality- and relevance-rated online literature service increased the utilization of evidence-based information from a digital library by practicing physicians.

  2. Validation of a short form of the Western Ontario and McMaster Universities Osteoarthritis Index function subscale in hip and knee osteoarthritis.

    PubMed

    Baron, Gabriel; Tubach, Florence; Ravaud, Philippe; Logeart, Isabelle; Dougados, Maxime

    2007-05-15

    A short version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function scale has recently been developed to enhance the applicability of the scale in routine practice and clinical research for patients with hip and knee osteoarthritis. The goal of the present study was to validate this short form. We conducted a prospective 4-week cohort study of 1,036 outpatients. Performance on the WOMAC function long form (LF) and short form (SF) was compared. Agreement between responses on the 2 forms was examined according to a Bland-Altman plot. Responsiveness to change (by standardized response mean [SRM]), reproducibility (intraclass correlation coefficient [ICC]), and internal consistency (Cronbach's alpha) were computed for both forms. Construct validity was assessed based on functional impairment as measured on a numerical rating scale. At baseline, 24% of patients who completed the WOMAC LF had missing data for at least 1 item as compared with only 6% of patients who completed the WOMAC SF. The mean WOMAC SF score was greater than the mean WOMAC LF score (mean +/- SD difference -4.3 +/- 4.8 on a 0-100 scale). SRMs were 0.61 and 0.73, ICCs were 0.76 and 0.68, and Cronbach's alphas were 0.93 and 0.85 for the WOMAC LF and SF, respectively. The 2 forms had comparable correlation with functional impairment. The WOMAC function short form has a low rate of missing data and is a responsive, reproducible, and valid measure. The mean SF score was 4 points higher than the mean LF score.

  3. Enhancing Involvement in Treatment Decision Making by Women with Breast Cancer

    DTIC Science & Technology

    2008-07-01

    Evaluation), McMaster University, Hamilton, Canada 1984 BHSc ( Physiotherapy ) McMaster University, Hamilton, Canada 1978 Diploma in Physiotherapy ...Mohawk College, Hamilton, Canada Certificate in Physiotherapy , McMaster University, Hamilton, Canada CURRENT STATUS AT MCMASTER UNIVERSITY 2001...University of York, United Kingdom 1985-1991 Clinical Education Co-ordinator, Mohawk-McMaster Physiotherapy Program, Mohawk College of Applied

  4. McMaster PLUS: A Cluster Randomized Clinical Trial of an Intervention to Accelerate Clinical Use of Evidence-based Information from Digital Libraries

    PubMed Central

    Haynes, R. Brian; Holland, Jennifer; Cotoi, Chris; McKinlay, R. James; Wilczynski, Nancy L.; Walters, Leslie A.; Jedras, Dawn; Parrish, Rick; McKibbon, K. Ann; Garg, Amit; Walter, Stephen D.

    2006-01-01

    Background Physicians have difficulty keeping up with new evidence from medical research. Methods We developed the McMaster Premium LiteratUre Service (PLUS), an internet-based addition to an existing digital library, which delivered quality- and relevance-rated medical literature to physicians, matched to their clinical disciplines. We evaluated PLUS in a cluster-randomized trial of 203 participating physicians in Northern Ontario, comparing a Full-Serve version (that included alerts to new articles and a cumulative database of alerts) with a Self-Serve version (that included a passive guide to evidence-based literature). Utilization of the service was the primary trial end-point. Results Mean logins to the library rose by 0.77 logins/month/user (95% CI 0.43, 1.11) in the Full-Serve group compared with the Self-Serve group. The proportion of Full-Serve participants who utilized the service during each month of the study period showed a sustained increase during the intervention period, with a relative increase of 57% (95% CI 12, 123) compared with the Self-Serve group. There were no differences in these proportions during the baseline period, and following the crossover of the Self-Serve group to Full-Serve, the Self-Serve group’s usage became indistinguishable from that of the Full-Serve group (relative difference 4.4 (95% CI −23.7, 43.0). Also during the intervention and crossover periods, measures of self-reported usefulness did not show a difference between the 2 groups. Conclusion A quality- and relevance-rated online literature service increased the utilization of evidence-based information from a digital library by practicing physicians. PMID:16929034

  5. Translation, adaptation and validation of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for an Arab population: the Sfax modified WOMAC.

    PubMed

    Guermazi, Mohammad; Poiraudeau, Serge; Yahia, Monem; Mezganni, Monia; Fermanian, Jacques; Habib Elleuch, M; Revel, Michel

    2004-06-01

    To translate into Arabic and validate the Western Ontario and McMaster Universities (WOMAC) index. Arabic translation was obtained with use of the forward and backward translation method. Adaptations were made after a pilot study. Patients with symptomatic knee OA fulfilling the revised criteria of the American College of Rheumatology were included. Impairment outcome measures (pain as measured on a visual analog scale, the maximum distance walked, Kellgren's radiological score), Lequesne index score and Beck depression scale score were recorded. Each item was analyzed. Test-retest reliability was assessed with use of the intra-class correlation coefficient (ICC) and the Bland and Altman method. Construct validity was investigated with use of Spearman's rank correlation coefficient, and a factor analysis was performed. One hundred and three patients were included in the study. Eight questions of the WOMAC physical function subscale (PF) had insufficient psychometric properties and were excluded. Although test-retest reliability of the questionnaire was good (0.84, 0.84, and 0.92 for pain, stiffness, and modified PF subscales respectively), construct validity could not be demonstrated. Factor analysis of the modified form of the WOMAC extracted four factors, which differed from the a priori triple stratification. However, factor analysis of the modified PF subscales extracted two factors, which accounted for 68.4% of the total variance and could be clinically characterized (disability during activities requiring knee flexion within the first 90 degrees and activities requiring knee flexion over more than 90 degrees ). We translated and adapted the WOMAC index into Arabic to suit Tunisian people. The translated questionnaire is reliable but not valid in its original form. We propose the use of a modified version of PF subscale of the WOMAC, although the psychometric properties of this instrument must be examined in a larger population.

  6. Enhancing Involvement in Treatment Decision Making by Women with Breast Cancer

    DTIC Science & Technology

    2007-07-01

    2003) 1995 MSc (Design, Measurement and Evaluation), McMaster University, Hamilton, Canada 1984 BHSc ( Physiotherapy ) McMaster University...Hamilton, Canada 1978 Diploma in Physiotherapy , Mohawk College, Hamilton, Canada Certificate in Physiotherapy , McMaster University, Hamilton...McMaster Physiotherapy Program, Mohawk College of Applied Arts and Technology, Hamilton, Ontario CLINICAL 1999- Physiotherapist, Hamilton Health

  7. Enhancing Involvement in Treatment Decision Making by Women With Breast Cancer

    DTIC Science & Technology

    2006-07-01

    Hamilton, Canada 1984 BHSc ( Physiotherapy ) McMaster University, Hamilton, Canada 1978 Diploma in Physiotherapy , Mohawk College, Hamilton...Canada Certificate in Physiotherapy , McMaster University, Hamilton, Canada CURRENT STATUS AT MCMASTER UNIVERSITY 2001-2006 Associate Clinical...United Kingdom 1985-1991 Clinical Education Co-ordinator, Mohawk-McMaster Physiotherapy Program, Mohawk College of Applied Arts and Technology

  8. Probabilistic risk assessment for a loss of coolant accident in McMaster Nuclear Reactor and application of reliability physics model for modeling human reliability

    NASA Astrophysics Data System (ADS)

    Ha, Taesung

    A probabilistic risk assessment (PRA) was conducted for a loss of coolant accident, (LOCA) in the McMaster Nuclear Reactor (MNR). A level 1 PRA was completed including event sequence modeling, system modeling, and quantification. To support the quantification of the accident sequence identified, data analysis using the Bayesian method and human reliability analysis (HRA) using the accident sequence evaluation procedure (ASEP) approach were performed. Since human performance in research reactors is significantly different from that in power reactors, a time-oriented HRA model (reliability physics model) was applied for the human error probability (HEP) estimation of the core relocation. This model is based on two competing random variables: phenomenological time and performance time. The response surface and direct Monte Carlo simulation with Latin Hypercube sampling were applied for estimating the phenomenological time, whereas the performance time was obtained from interviews with operators. An appropriate probability distribution for the phenomenological time was assigned by statistical goodness-of-fit tests. The human error probability (HEP) for the core relocation was estimated from these two competing quantities: phenomenological time and operators' performance time. The sensitivity of each probability distribution in human reliability estimation was investigated. In order to quantify the uncertainty in the predicted HEPs, a Bayesian approach was selected due to its capability of incorporating uncertainties in model itself and the parameters in that model. The HEP from the current time-oriented model was compared with that from the ASEP approach. Both results were used to evaluate the sensitivity of alternative huinan reliability modeling for the manual core relocation in the LOCA risk model. This exercise demonstrated the applicability of a reliability physics model supplemented with a. Bayesian approach for modeling human reliability and its potential

  9. Validation of the Spanish version of the WOMAC questionnaire for patients with hip or knee osteoarthritis. Western Ontario and McMaster Universities Osteoarthritis Index.

    PubMed

    Escobar, A; Quintana, J M; Bilbao, A; Azkárate, J; Güenaga, J I

    2002-11-01

    The aim of this study was to validate a translated version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire in Spanish patients with hip or knee osteoarthritis (OA). The WOMAC questionnaire and the SF-36 were administered to a sample of 269 patients on the waiting list for hip or knee replacement. We studied the convergent validity and the item-scale correlation using Pearson's correlation coefficient and Spearman's pi. For the reliability study we used another sample of 58 patients who received the WOMAC twice within 15 days. The Pearson's, Spearman's pi, and intraclass correlation coefficients were calculated. Internal consistency was measured by Cronbach's alpha. The responsiveness study was carried out by resending the two questionnaires to all patients 6 months after surgical intervention; responsiveness was measured by means of the paired t-test, the effect size I and the standardised response mean. The Pearson's coefficients for the convergent validity ranged from -0.52 to -0.63. The coefficients obtained for the item-scale correlation of the pain area were 0.74 or higher, 0.91 or higher for stiffness, and 0.61 or higher for function. When measuring the test-retest reliability, the coefficients ranged from 0.66 to 0.81. Internal consistency yielded a Cronbach's alpha ranging from 0.81 to 0.93. The responsiveness showed an effect size I ranging from 1.5 to 2.2 in patients who underwent hip replacement; for those who underwent knee replacement the range was 1 to 1.8. The standardised response mean ranged from 1.3 to 1.9 for patients with hip OA; those with knee OA ranged from 0.8 to 1.5. The Spanish version of WOMAC is a valid, reliable and responsive instrument in patients with hip or knee OA.

  10. Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee.

    PubMed

    Salaffi, F; Leardini, G; Canesi, B; Mannoni, A; Fioravanti, A; Caporali, R; Lapadula, G; Punzi, L

    2003-08-01

    The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis (OA) Index is a tested questionnaire to assess symptoms and physical functional disability in patients with OA of the knee and the hip. We adapted the WOMAC for the Italian language and tested its metric properties in 304 patients with symptomatic OA of the knee. Three hundred and four consecutive patients, attending 29 rheumatologic outpatient clinic in northern, central, and southern Italy, were asked to answer two disease-specific questionnaires (WOMAC and Lequesne algofunctional index) and one generic instrument (Medical Outcomes Study SF-36 Health Survey-MOS SF-36). A sample of 258 patients was readministered the WOMAC 7-10 days after the first visit and the structured interview, which also assessed demographic and other characteristics. Internal consistency was assessed using Cronbach's alpha, reliability using intraclass correlation coefficients (ICCs), and construct and discriminant validity using Spearman's correlations, Wilcoxon rank sum test, and Kruskal-Wallis test. All WOMAC subscales (pain, stiffness, and physical function) were internally consistent with Cronbach's coefficient alpha of 0.91, 0.81, and 0.84, respectively. Test-retest reliability was satisfactory with ICCs of 0.86, 0.68, and 0.89, respectively. In comparison with the SF-36, the expected correlations were found when comparing items measuring similar constructs, supporting the concepts of convergent construct validity. Very high correlations were also obtained between WOMAC scores and Lequesne OA algofunctional index. WOMAC physical function, but not WOMAC stiffness and pain subscales, was weakly associated with radiological OA severity (P=0.03). Also, WOMAC pain score was inversely correlated (P=0.01) with years of formal education. Examination of discriminant validity showed that the scores on the WOMAC and SF-36 followed hypothesized patterns: the WOMAC discriminated better among subjects with varying severity of

  11. Comparing the lower limb tasks questionnaire to the Western Ontario and McMaster Universities Osteoarthritis Index: agreement, responsiveness, and convergence with physical performance for knee osteoarthritis patients.

    PubMed

    McKay, Carly; Prapavessis, Harry; McNair, Peter

    2013-03-01

    To compare the Lower Limb Tasks Questionnaire (LLTQ) with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in terms of agreement, responsiveness, and convergence. Cross-sectional with an exploratory repeated-measures subsample analysis. Community-based seniors' centers and arthritis clinics. Individuals with symptomatic knee osteoarthritis (N=76) participated, with a subsample of 18 participants contributing to the pre- and postarthroplasty subanalysis. Not applicable. Bland and Altman plots of agreement with 95% limits of agreement, statistical responsiveness, and standardized response mean (SRM) were calculated for LLTQ and WOMAC subscales. Both t tests and Wilcoxon rank-sum tests were used to examine changes in pre- and postarthroplasty self-reported function, 50-ft walk speed, stair ascent/descent speed, and isometric quadriceps strength. The agreement (bias) of the LLTQ activities of daily living (ADL) subscale when compared with the WOMAC physical function (PF) subscale was 1%±10% (mean ± SD), and the 95% limits of agreement were -19% to +22%. The statistical responsiveness of the WOMAC-PF and LLTQ ADL was 1.17 and -.63, respectively. The SRMs for these scales were .90 and -.61, respectively. The WOMAC-PF scores showed a notable improvement over the first 6 weeks postarthroplasty, while LLTQ ADL scores were unchanged. The objective measures of function were all significantly worse at 6 weeks. The LLTQ demonstrated adequate agreement with the WOMAC and acceptable responsiveness for use in place of the WOMAC in nonspecialized clinics. The LLTQ may more accurately represent functional status after total knee arthroplasty, but further study in larger samples is recommended. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  12. Comparison of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index and a self-report format of the self-administered Lequesne-Algofunctional index in patients with knee and hip osteoarthritis.

    PubMed

    Stucki, G; Sangha, O; Stucki, S; Michel, B A; Tyndall, A; Dick, W; Theiler, R

    1998-03-01

    To compare the metric properties and validity of German versions of the WOMAC (Western Ontario and McMaster Universities) and a self-administered questionnaire-format of the Lequesne-Algofunctional-Index in patients with osteoarthritis (OA) of the lower extremities. Cross-sectional analysis of the instruments' internal consistency (Cronbach's coefficient alpha) and construct validity (correlation with radiological OA-severity and limitation in range-of-motion) in ambulatory patients and patients before hip arthroplasty. Test-retest reliability was assessed on a subsample after 10 days. Data from 51 patients out of 91 contacted could be analyzed. Twenty-nine patients had knee and 22 patients had hip OA. Both the WOMAC and Lequesne OA-indices and their scales or sections had a satisfactory test-retest reliability (Intraclass correlation coefficient 0.43-0.96). All scales of the WOMAC were internally consistent (Cronbach's coefficient alpha 0.81-0.96) and associated with radiological OA-severity and joint range of motion. However, only the function but not the symptom sections (Cronbach's coefficient alpha knee: 0.55; hip: 0.63) of the self-administered Lequesne OA index were internally consistent for both, patients with knee and hip OA. Also, the symptom components were not or only weakly associated with radiological OA-severity and joint range of motion. Although our results are based on a German version using a self-report format we may caution using the self-administered Lequesne OA index without prior testing of its metric properties and validity.

  13. Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for elderly patients with a femoral neck fracture.

    PubMed

    Burgers, Paul T P W; Poolman, Rudolf W; Van Bakel, Theodorus M J; Tuinebreijer, Wim E; Zielinski, Stephanie M; Bhandari, Mohit; Patka, Peter; Van Lieshout, Esther M M

    2015-05-06

    The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture. Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older. The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%). The WOMAC showed good

  14. Differences between Mothers' and Fathers' Ratings of Family Functioning with the Family Assessment Device: The Validity of Combined Parent Scores

    ERIC Educational Resources Information Center

    Cooke, Dawson; Marais, Ida; Cavanagh, Robert; Kendall, Garth; Priddis, Lynn

    2015-01-01

    The psychometric properties of the General Functioning subscale of the McMaster Family Assessment Device were examined using the Rasch Model (N = 237 couples). Mothers' and fathers' ratings of the General Functioning subscale of the McMaster Family Assessment Device are recommended, provided these are analyzed separately. More than a quarter of…

  15. Influence of Geometry on a High Surface Area-Solid Phase Microextraction Sampler for Chemical Vapor Collection

    DTIC Science & Technology

    2007-06-04

    LCDR Greg Cook , PhD Date...Science Research Unit • Dr. Robert Mustacich of RVM Scientific • My thesis advisory committee: LtCol Peter LaPuma, LCDR Greg Cook , and Dr. Brian...which constitutes a mass spectrum. A computer compares the mass spectrum to a mass spectral library like a fingerprint. (McMaster and McMaster, 1997

  16. Affinity Probe Capillary Electrophoresis Evaluation of Aptamer Binding to Campylobacter jejuni Bacteria

    DTIC Science & Technology

    2009-11-01

    absorption coefficients (260nm) of 173,100 M cm–1. Desired stock solutions were freshly prepared with tris- borate ethylenediaminetetraacetic acid (EDTA... McMasters , and Paul M. Pellegrino ARL-TR-5015 November 2009 Approved for public release...Aptamer Binding to Campylobacter jejuni Bacteria Dimitra N. Stratis-Cullum, Sun McMasters , and Paul M. Pellegrino Sensors and Electron Devices

  17. Cross-cultural adaptation, reliability and validity of the Arabic version of the reduced Western Ontario and McMaster Universities Osteoarthritis index in patients with knee osteoarthritis.

    PubMed

    Alghadir, Ahmad; Anwer, Shahnawaz; Iqbal, Zaheen Ahmed; Alsanawi, Hisham Abdulaziz

    2016-01-01

    We adapted the reduced Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index for the Arabic language and tested its metric properties in patients with knee osteoarthritis (OA). One hundred and twenty-one consecutive patients who were referred for physiotherapy to the outpatient department were asked to answer the Arabic version of the reduced WOMAC index (ArWOMAC). After the completion of the ArWOMAC, the intensity of knee pain and general health status were assessed using the visual analog scale (VAS) and the 12-item short form health survey (SF-12), respectively. A second assessment was performed at least 48 h after the first session to assess test-retest reliability. The test-retest reliability was quantified using the intra-class correlation coefficient (ICC), and Cronbach's alpha was calculated to assess the internal consistency of the Arabic questionnaire. The construct validity was assessed using Spearman rank correlation coefficients. The total ArWOMAC scale and pain and function subscales were internally consistent with Cronbach's coefficient alpha of 0.91, 0.89 and 0.90, respectively. Test-retest reliability was good to excellent with ICC of 0.91, 0.89 and 0.90, respectively. SF-12 and VAS score significantly correlated with ArWOMAC index (p < 0.01), which support the construct validity. The standard error of measurement (SEM) of the total scale was 2.94, based on repeated measurements for test-retest. The minimum detectable change based on the SEM for test-retest was 8.15. The ArWOMAC index is a reliable and valid instrument for evaluating the severity of knee OA, with metric properties in agreement with the original version. Although, the reduced WOMAC index has been clinically utilized within the Saudi population, the Arabic version of this instrument is not validated for an Arab population to measure lower limb functional disability caused by OA. The Arabic version of reduced WOMAC (ArWOMAC) index is a reliable and valid scale

  18. A Comparative Study of Four Methods for the Detection of Nematode Eggs and Large Protozoan Cysts in Mandrill Faecal Material.

    PubMed

    Pouillevet, Hanae; Dibakou, Serge-Ely; Ngoubangoye, Barthélémy; Poirotte, Clémence; Charpentier, Marie J E

    2017-01-01

    Coproscopical methods like sedimentation and flotation techniques are widely used in the field for studying simian gastrointestinal parasites. Four parasites of known zoonotic potential were studied in a free-ranging, non-provisioned population of mandrills (Mandrillus sphinx): 2 nematodes (Necatoramericanus/Oesophagostomum sp. complex and Strongyloides sp.) and 2 protozoan species (Balantidium coli and Entamoeba coli). Different coproscopical techniques are available but they are rarely compared to evaluate their efficiency to retrieve parasites. In this study 4 different field-friendly methods were compared. A sedimentation method and 3 different McMaster methods (using sugar, salt, and zinc sulphate solutions) were performed on 47 faecal samples collected from different individuals of both sexes and all ages. First, we show that McMaster flotation methods are appropriate to detect and thus quantify large protozoan cysts. Second, zinc sulphate McMaster flotation allows the retrieval of a higher number of parasite taxa compared to the other 3 methods. This method further shows the highest probability to detect each of the studied parasite taxa. Altogether our results show that zinc sulphate McMaster flotation appears to be the best technique to use when studying nematodes and large protozoa. © 2017 S. Karger AG, Basel.

  19. Field Validity and Feasibility of Four Techniques for the Detection of Trichuris in Simians: A Model for Monitoring Drug Efficacy in Public Health?

    PubMed Central

    Levecke, Bruno; De Wilde, Nathalie; Vandenhoute, Els; Vercruysse, Jozef

    2009-01-01

    Background Soil-transmitted helminths, such as Trichuris trichiura, are of major concern in public health. Current efforts to control these helminth infections involve periodic mass treatment in endemic areas. Since these large-scale interventions are likely to intensify, monitoring the drug efficacy will become indispensible. However, studies comparing detection techniques based on sensitivity, fecal egg counts (FEC), feasibility for mass diagnosis and drug efficacy estimates are scarce. Methodology/Principal Findings In the present study, the ether-based concentration, the Parasep Solvent Free (SF), the McMaster and the FLOTAC techniques were compared based on both validity and feasibility for the detection of Trichuris eggs in 100 fecal samples of nonhuman primates. In addition, the drug efficacy estimates of quantitative techniques was examined using a statistical simulation. Trichuris eggs were found in 47% of the samples. FLOTAC was the most sensitive technique (100%), followed by the Parasep SF (83.0% [95% confidence interval (CI): 82.4–83.6%]) and the ether-based concentration technique (76.6% [95% CI: 75.8–77.3%]). McMaster was the least sensitive (61.7% [95% CI: 60.7–62.6%]) and failed to detect low FEC. The quantitative comparison revealed a positive correlation between the four techniques (Rs = 0.85–0.93; p<0.0001). However, the ether-based concentration technique and the Parasep SF detected significantly fewer eggs than both the McMaster and the FLOTAC (p<0.0083). Overall, the McMaster was the most feasible technique (3.9 min/sample for preparing, reading and cleaning of the apparatus), followed by the ether-based concentration technique (7.7 min/sample) and the FLOTAC (9.8 min/sample). Parasep SF was the least feasible (17.7 min/sample). The simulation revealed that the sensitivity is less important for monitoring drug efficacy and that both FLOTAC and McMaster were reliable estimators. Conclusions/Significance The results of this study

  20. Surgeons’ and residents’ double-gloving practices at 2 teaching hospitals in Ontario

    PubMed Central

    Haines, Ted; Stringer, Bernadette; Herring, Jeremy; Thoma, Achilleas; Harris, Kenneth A.

    2011-01-01

    Background Surgeons and residents are at increased risk of exposure to blood-borne pathogens owing to percutaneous injury (PI) and contamination. One method known to reduce risk is double-gloving (DG) during surgery. Methods All surgeons and residents affiliated with the University of Western Ontario (UWO) and McMaster University in 2005 were asked to participate in a Web-based survey. The survey asked respondents their specialty, the number of operations they participated in per week, their age and sex, the proportion of surgeries in which they double-gloved (DG in ≥ 75% surgeries was considered to be routine), and the average number of PIs they sustained per year and whether or not they reported them to an employee health service. Results In total, 155 of 331 (47%) eligible surgeons and residents responded; response rates for UWO and McMaster surgeons were 50% and 39%, respectively, and for UWO and McMaster residents, they were 52% and 47%, respectively. A total of 43% of surgeons and residents reported routine DG; 50% from McMaster and 36% from UWO. Using logistic regression to simultaneously adjust for participant characteristics, we confirmed that DG was more frequent at McMaster than at UWO, with an odds ratio of 3.32 (95% confidence interval 1.35–8.17). Surgeons and residents reported an average of 3.3 surgical PIs per year (2.2 among McMaster participants and 4.5 among UWO participants). Of the 77% who reported at least 1 injury/year, 67% stated that they had not reported it to an employee health service. Conclusion Percutaneous injuries occur frequently during surgery, yet routine DG, an effective means of reducing risk, was carried out by less than half of the surgeons and residents participating in this study. This highlights the need for a more concerted and broad-based approach to increase the use of a measure that is effective, inexpensive and easily carried out. PMID:21251417

  1. Easily Processed Host-Guest Polymer Systems with High-Tg Characteristics (First-year Report)

    DTIC Science & Technology

    2012-05-01

    manner such that the effective electro- optical coefficient is maximized. Unfortunately, relaxation of the chromophore in the host polymer leads to...polished stainless steel facing plates (0.25 in thickness, McMaster ) and window molds cut from aluminum stock (1 mm thickness, McMaster ). Both facing...plasticization from the chromophore. Both chromophores resulted in substantial red-shifted absorption compared to a sample prepared in virgin PMMA. We expect

  2. The contribution of simple random sampling to observed variations in faecal egg counts.

    PubMed

    Torgerson, Paul R; Paul, Michaela; Lewis, Fraser I

    2012-09-10

    It has been over 100 years since the classical paper published by Gosset in 1907, under the pseudonym "Student", demonstrated that yeast cells suspended in a fluid and measured by a haemocytometer conformed to a Poisson process. Similarly parasite eggs in a faecal suspension also conform to a Poisson process. Despite this there are common misconceptions how to analyse or interpret observations from the McMaster or similar quantitative parasitic diagnostic techniques, widely used for evaluating parasite eggs in faeces. The McMaster technique can easily be shown from a theoretical perspective to give variable results that inevitably arise from the random distribution of parasite eggs in a well mixed faecal sample. The Poisson processes that lead to this variability are described and illustrative examples of the potentially large confidence intervals that can arise from observed faecal eggs counts that are calculated from the observations on a McMaster slide. Attempts to modify the McMaster technique, or indeed other quantitative techniques, to ensure uniform egg counts are doomed to failure and belie ignorance of Poisson processes. A simple method to immediately identify excess variation/poor sampling from replicate counts is provided. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Modified flotation method with the use of Percoll for the detection of Isospora suis oocysts in suckling piglet faeces.

    PubMed

    Karamon, Jacek; Ziomko, Irena; Cencek, Tomasz; Sroka, Jacek

    2008-10-01

    The modification of flotation method for the examination of diarrhoeic piglet faeces for the detection of Isospora suis oocysts was elaborated. The method was based on removing fractions of fat from the sample of faeces by centrifugation with a 25% Percoll solution. The investigations were carried out in comparison to the McMaster method. From five variants of the Percoll flotation method, the best results were obtained when 2ml of flotation liquid per 1g of faeces were used. The limit of detection in the Percoll flotation method was 160 oocysts per 1g, and was better than with the McMaster method. The efficacy of the modified method was confirmed by results obtained in the examination of the I. suis infected piglets. From all faecal samples, positive samples in the Percoll flotation method were double the results than that of the routine method. Oocysts were first detected by the Percoll flotation method on day 4 post-invasion, i.e. one-day earlier than with the McMaster method. During the experiment (except for 3 days), the extensity of I. suis invasion in the litter examined by the Percoll flotation method was higher than that with the McMaster method. The obtained results show that the modified flotation method with the use of Percoll could be applied in the diagnostics of suckling piglet isosporosis.

  4. Predicting doctor performance outcomes of curriculum interventions: problem-based learning and continuing competence.

    PubMed

    Norman, Geoffrey R; Wenghofer, Elizabeth; Klass, Daniel

    2008-08-01

    Problem-based learning (PBL) is an educational strategy designed to enhance self-assessment, self-directed learning and lifelong learning. The present study examines a peer review programme to determine whether the impact of PBL on continuing competence can be detected in practice. This study aimed to establish whether McMaster graduates who graduated between 1972 and 1991 were any less likely to be identified as having issues of competence by a systematic peer review programme than graduates of other Ontario medical schools. We identified a total of 1166 doctors who had graduated after 1972 and had completed a mandated peer review programme. Of these, 108 had graduated from McMaster and 857 from other Canadian schools. School of graduation was cross-tabulated against peer rating. A secondary analysis examined predictors of ratings using multiple regression. We found that 4% of McMaster graduates and 5% of other graduates were deemed to demonstrate cause for concern or serious concern, and that 24% of McMaster doctors and 28% of other doctors were rated as excellent. These differences were not significant. Multiple regression indicated that certification by family medicine or a specialty, female gender and younger age were all predictors of practice outcomes, but school of graduation was not. There is no evidence from this study that PBL graduates are better able to maintain competence than graduates of conventional schools. The study highlights potential problems in attempting to link undergraduate educational interventions to doctor performance outcomes.

  5. Correlations among measures of knee stiffness, gait performance and complaints in individuals with knee osteoarthritis.

    PubMed

    Oatis, Carol A; Wolff, Edward F; Lockard, Margery A; Michener, Lori A; Robbins, Steven J

    2013-03-01

    Stiffness is a common complaint in individuals with knee osteoarthritis and is a component of the osteoarthritis diagnosis. Yet the relationship between stiffness and function is poorly understood and methods to quantify stiffness are limited. Using a cross-sectional observational design with 66 subjects with knee osteoarthritis, stiffness and damping coefficients were calculated from a relaxed knee oscillation procedure. Gait parameters were measured using an electronic walkway. Self-reported pain, stiffness, and function were measured with the Western Ontario and McMaster Osteoarthritis Index. Correlation and Alexander's normalized-t approximation analyses were used to assess associations among the variables. Subset analysis was performed on subjects with and without tibiofemoral joint crepitus. Slight to moderate correlations existed between stiffness and damping coefficients and most gait parameters ((| r |=0.30-0.56; P<.05) and between Western Ontario and McMaster Osteoarthritis Index scores and all gait parameters (| r |=0.35-0.62; P<.05). The damping coefficient was only slightly associated with patient-rated Western Ontario and McMaster Osteoarthritis Index stiffness subscale scores. Subset analysis revealed significant correlations that differed between those with and without crepitus. These findings suggest that laboratory measured stiffness and damping coefficients, Western Ontario and McMaster Osteoarthritis Index scores and gait-related measurements assess different aspects related to movement in individuals with knee osteoarthritis. Stiffness and damping coefficients may offer the ability to explain gait changes in the knee that are independent of a person's perceptions particularly in the early stages of the disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Lithium target performance evaluation for low-energy accelerator-based in vivo measurements using gamma spectroscopy.

    PubMed

    Aslam; Prestwich, W V; McNeill, F E

    2003-03-01

    The operating conditions at McMaster KN Van de Graaf accelerator have been optimized to produce neutrons via the (7)Li(p, n)(7)Be reaction for in vivo neutron activation analysis. In a number of earlier studies (development of an accelerator based system for in vivo neutron activation analysis measurements of manganese in humans, Ph.D. Thesis, McMaster University, Hamilton, ON, Canada; Appl. Radiat. Isot. 53 (2000) 657; in vivo measurement of some trace elements in human Bone, Ph.D. Thesis. McMaster University, Hamilton, ON, Canada), a significant discrepancy between the experimental and the calculated neutron doses has been pointed out. The hypotheses formulated in the above references to explain the deviation of the experimental results from analytical calculations, have been tested experimentally. The performance of the lithium target for neutron production has been evaluated by measuring the (7)Be activity produced as a result of (p, n) interaction with (7)Li. In contradiction to the formulated hypotheses, lithium target performance was found to be mainly affected by inefficient target cooling and the presence of oxides layer on target surface. An appropriate choice of these parameters resulted in neutron yields same as predicated by analytical calculations.

  7. Computer Conferencing in Health Sciences: CoSy at McMaster

    PubMed Central

    Ahmed, K.; Ridley, M.

    1988-01-01

    Computer conferencing systems provide a novel and economical way to exchange ideas and maintain fruitful collaboration across wide distances. There is considerable potential value in using conferencing system in research, education, case discussion and administration. The early experience is encouraging. We discuss a number of ways in which CoSy is being used in Health Sciences.

  8. Sidescan-sonar imagery, multibeam bathymetry, and surficial geologic interpretations of the sea floor in Rhode Island Sound, off Sakonnet Point, Rhode Island

    USGS Publications Warehouse

    McMullen, Katherine Y.; Poppe, Lawrence J.; Twomey, Erin R.; Danforth, William W.; Haupt, Todd A.; Crocker, James M.

    2007-01-01

    The U.S. Geological Survey (USGS) is working with the National Oceanic and Atmospheric Administration (NOAA) to interpret the surficial geology in estuaries and sounds along the northeastern coast of the United States. This report interprets the area covered by NOAA Survey H11320, about 72 km² of sea floor in eastern Rhode Island Sound (RIS), located about 8 km south of Sakonnet Point, Rhode Island (fig. 1). Previous work in RIS includes studies of both sea-floor processes and subsurface geologic framework. McMaster (1960) mapped surficial sediment samples in Narragansett Bay and RIS and McMaster and others (1968) conducted a seismic-reflection survey in Block Island Sound and RIS. O'Hara and Oldale (1980) collected seismic-reflection profiles, sidescan-sonar data, and vibracores in eastern RIS (fig. 2). They interpreted the geologic history, assessed sand and gravel resources, and evaluated the mining impact of these resources. McMaster's (1960) interpretation of the surficial sediment within this study area consisted of sand with several isolated areas of gravel. Several other sediment samples were previously obtained within the study area: three National Oceanographic Data Center (NODC) dredge samples from 1942 consisted of sand and one National Ocean Service (NOS) sample from 1939 was rocky (fig. 2; Poppe and others, 2003). The purpose of this report is to define the sea-floor morphology and sedimentary environments and interpret processes occurring on the sea floor using sidescan-sonar imagery, multibeam bathymetry, and historic seismic-reflection profiles.

  9. Mitochondrial DNA Sequence Variation in North Atlantic Long-Finned Pilot Whales, Globicephala melas

    DTIC Science & Technology

    1994-06-01

    Delphinapterus leucas : mitochondrial DNA sequence variation within and among North American populations. M.Sc. thesis. McMaster University. Brown, G.G...Delphinapteras leucas ) (Brennin 1992), minke whales {Balaenoptera acutorostratd) (Wada et al. 1991), bottlenose dolphins {Tursiops truncatus) (Dowling & Brown

  10. CARD 2017: expansion and model-centric curation of the Comprehensive Antibiotic Resistance Database

    USDA-ARS?s Scientific Manuscript database

    The Comprehensive Antibiotic Resistance Database (CARD; http://arpcard.mcmaster.ca) is a manually curated resource containing high quality reference data on the molecular basis of antimicrobial resistance (AMR), with an emphasis on the genes, proteins, and mutations involved in AMR. CARD is ontologi...

  11. University Curricula in the Marine Sciences and Related Fields. Academic Years 1969-70 and 1970-71.

    DTIC Science & Technology

    1971-01-01

    Associate Professor Krause , Dale C., Associate Professor 112 McMaster, Robert L., Ph.D., Associate Professor Smayda, Theodore J., Dr., Philos...Associate Professor of Zoology Division of Physical Sciences Allison, Edwin C., Ph.D., Professor of Geology Berger, Wolfgang , Ph.D., Assistant Professor of

  12. Family Practice: A Proposed Solution to the Problem of Meeting the Medical Needs of the Community

    PubMed Central

    McAuley, R. G.

    1967-01-01

    Difficulties in meeting today's community medical needs are outlined, followed by a proposed solution in which the first-contact physician is the trained family physician. The McMaster Family Practice Course is described. The potential research contribution of a Department of Family Medicine is stressed. PMID:6020551

  13. The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

    ERIC Educational Resources Information Center

    Moore, Crystal Dea

    2010-01-01

    A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden,…

  14. Health Informatics for Neonatal Intensive Care Units: An Analytical Modeling Perspective

    PubMed Central

    Mench-Bressan, Nadja; McGregor, Carolyn; Pugh, James Edward

    2015-01-01

    The effective use of data within intensive care units (ICUs) has great potential to create new cloud-based health analytics solutions for disease prevention or earlier condition onset detection. The Artemis project aims to achieve the above goals in the area of neonatal ICUs (NICU). In this paper, we proposed an analytical model for the Artemis cloud project which will be deployed at McMaster Children’s Hospital in Hamilton. We collect not only physiological data but also the infusion pumps data that are attached to NICU beds. Using the proposed analytical model, we predict the amount of storage, memory, and computation power required for the system. Capacity planning and tradeoff analysis would be more accurate and systematic by applying the proposed analytical model in this paper. Numerical results are obtained using real inputs acquired from McMaster Children’s Hospital and a pilot deployment of the system at The Hospital for Sick Children (SickKids) in Toronto. PMID:27170907

  15. Joint demosaicking and zooming using moderate spectral correlation and consistent edge map

    NASA Astrophysics Data System (ADS)

    Zhou, Dengwen; Dong, Weiming; Chen, Wengang

    2014-07-01

    The recently published joint demosaicking and zooming algorithms for single-sensor digital cameras all overfit the popular Kodak test images, which have been found to have higher spectral correlation than typical color images. Their performance perhaps significantly degrades on other datasets, such as the McMaster test images, which have weak spectral correlation. A new joint demosaicking and zooming algorithm is proposed for the Bayer color filter array (CFA) pattern, in which the edge direction information (edge map) extracted from the raw CFA data is consistently used in demosaicking and zooming. It also moderately utilizes the spectral correlation between color planes. The experimental results confirm that the proposed algorithm produces an excellent performance on both the Kodak and McMaster datasets in terms of both subjective and objective measures. Our algorithm also has high computational efficiency. It provides a better tradeoff among adaptability, performance, and computational cost compared to the existing algorithms.

  16. Neutron Scattering Facilities

    Science.gov Websites

    Low Energy Neutron Source (LENS), Indiana University Cyclotron Facility, USA McMaster Nuclear Reactor Research, Gaithersburg, Maryland, USA Peruvian Institute of Nuclear Energy (IPEN), Lima, Peru Spallation Nuclear Science and Technology Organisation, Lucas Heights, Australia High-flux Advanced Neutron

  17. The Role of BRCA1 in Lethal Prostate Cancer

    DTIC Science & Technology

    2013-08-01

    Positive 5% Positive 12% -15- Figure II. Correlation coefficients of mRNA expression of 28,000 genes within technical replicates for an 11-year old tissue...Transdisciplinary Prostate Cancer Partnership (ToPCaP, topcapteam.org) 1Division of Urology, McMaster University, Hamilton, ON, Canada 2Department of

  18. The Medical Literature as a Resource for Health Care Practice.

    ERIC Educational Resources Information Center

    McKibbon, K. Ann; And Others

    1995-01-01

    Discussion of evidence-based medicine (EBM) focuses on information tools to facilitate the practice of EBM that were developed, evaluated, and made more accessible by the McMaster University (Canada) Faculty of Health Sciences. Highlights include users' guides to medical literature, strategies for improving MEDLINE searches, new journals, and…

  19. An 8-week multimodal treatment program improves symptoms of knee osteoarthritis: a real-world multicenter experience

    PubMed Central

    Miller, Larry E; Block, Jon E

    2013-01-01

    Purpose To report outcomes from a 5-year real-world clinical experience with a multimodal treatment program in patients with symptomatic knee osteoarthritis (OA). Methods Patients with symptomatic, radiographically confirmed knee OA resistant to traditional conservative treatments underwent a supervised 8-week multimodal treatment program consisting of low-impact aerobic exercise, muscle flexibility exercises, joint mobilization, physical therapy modalities, muscle strengthening and functional training, patient education, and a series of 3 or 5 weekly hyaluronic acid injections. Patients were evaluated at admission, 4 weeks, and 8 weeks. Patient-reported outcomes included knee pain severity using an 11-point (0–10) numerical scale and the Western Ontario and McMaster Universities Osteoarthritis Index. Results A total of 3,569 patients completed an 8-week treatment course between January 2008 and April 2013 at 66 dedicated treatment centers in the United States. Knee pain severity assessed on a numeric scale decreased 59% on average, from 5.4±2.9 to 2.2±2.2 (P<0.001). Western Ontario and McMaster Universities Osteoarthritis Index subscores decreased by 44% to 51% (all P<0.001) during the 8-week program. The percentage of patients achieving the threshold for Western Ontario and McMaster Universities Osteoarthritis Index minimally perceptible clinical improvement was 79% for the Pain subscale, 75% for Function, and 76% for Stiffness. Favorable patient outcomes were reported in all subgroups, regardless of age, sex, body mass index, disease severity, or number of treatment cycles. Discussion A real-world 8-week multimodal treatment program results in clinically meaningful improvements in knee OA symptoms, with excellent generalizability across a broad range of patient characteristics. PMID:27774023

  20. Family medicine residents' practice intentions: Theory of planned behaviour evaluation.

    PubMed

    Grierson, Lawrence E M; Fowler, Nancy; Kwan, Matthew Y W

    2015-11-01

    To assess residents' practice intentions since the introduction of the College of Family Physicians of Canada's Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. A survey based on Ajzen's theory of planned behaviour was administered on 2 occasions. McMaster University in Hamilton, Ont. Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. The survey was modeled so as to measure the respondents' intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents' intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University.

  1. Proposed Strategic Mandates for Ontario Universities: An Organizational Theory Perspective

    ERIC Educational Resources Information Center

    Buzzelli, Michael; Allison, Derek J.

    2017-01-01

    This paper presents an empirical analysis of the Ontario-led strategic mandate agreement (SMA) planning exercise. Focusing on the self-generated strategic mandates of five universities (McMaster, Ottawa, Queen's, Toronto, and Western), we asked how universities responded to this exercise of strategic visioning? The answer to this question is…

  2. Forging an American Grand Strategy: Securing a Path Through a Complex Future

    DTIC Science & Technology

    2013-10-01

    rounded U.S. representative. Generals Petrae - us and H. R. McMaster both went to civilian schools (Princeton and University of North Carolina Cha- pel...Joint Chiefs of Staff U.S. Army General Martin Dempsey graduated from the National War College, as did Air Force Chief of Staff General Norton

  3. Mothers of Children with Developmental Disorders in the Bedouin Community in Israel: Family Functioning, Caregiver Burden, and Coping Abilities

    ERIC Educational Resources Information Center

    Manor-Binyamini, Iris

    2011-01-01

    This preliminary study compares the family functioning, caregiver burden, and coping abilities between mothers of 300 children with developmental disorders and mothers of 100 children with no such disorders in the Bedouin community in Israel. The mothers completed the McMaster Family Assessment Device Scale, the Caregiver Burden Index, and the…

  4. The Differential Impact of Clerk Interest and Participation in a Child and Adolescent Psychiatry Clerkship Rotation upon Psychiatry and Pediatrics Residency Matches

    ERIC Educational Resources Information Center

    Hanson, Mark D.; Szatmari, Peter; Eva, Kevin W.

    2011-01-01

    Objective: The authors evaluated the differential impact of clerk interest and participation in a Child and Adolescent Psychiatry (CAP) clerkship rotation upon psychiatry and pediatrics residency matches. Method: Authors studied clerks from the McMaster University M.D. program graduating years of 2005-2007. Participants were categorized as 1)…

  5. The Portable Patient Problem Pack: A Problem-Based Learning Unit

    ERIC Educational Resources Information Center

    Barrows, Howard S.; Tamblyn, Robyn M.

    1977-01-01

    The Portable Patient Problem Pack (P4), a method of simulating a patient's problem in a card deck format, is designed to develop the student's problem-solving or diagnostic skills in a manner consistent with the skills of the practicing clinician. Its effectiveness at McMaster University is reported. (LBH)

  6. Enhancement of Pedagogical Skills in Nigerian Schools through Information and Communication Technology (ICT): Issues for the Future

    ERIC Educational Resources Information Center

    Aluede, Oyaziwo

    2013-01-01

    The history of information and communication technology (ICT) in Nigerian schools is patchy. The first experience of Internet services started about 1990 with University of Ilorin through the assistance of McMaster University in Canada. Currently, though, many staff members of universities in Nigeria have email accounts, and over forty-four…

  7. Computer-Mediated Communications Systems: Will They Catch On?

    ERIC Educational Resources Information Center

    Cook, Dave; Ridley, Michael

    1990-01-01

    Describes the use of CoSy, a computer conferencing system, by academic librarians at McMaster University in Ontario. Computer-mediated communications systems (CMCS) are discussed, the use of the system for electronic mail and computer conferencing is described, the perceived usefulness of CMCS is examined, and a sidebar explains details of the…

  8. The Impact of Intellectual Disability, Caregiver Burden, Family Functioning, Marital Quality, and Sense of Coherence

    ERIC Educational Resources Information Center

    Al-Krenawi, Alean; Graham, John R.; Al Gharaibeh, Fakir

    2011-01-01

    The present article is the first to consider the impact of intellectual disability on Bedouin-Arab families' caregiver burden, family functioning, marital quality, and sense of coherence. A random sample of 300 Bedouin-Arab parents with one or more intellectually disabled children, and a control group (n = 100) completed the McMaster Family…

  9. Teachers' Use of an Instructional Coach and Teachers' Perceived Sense of Self-Efficacy: A Correlational Study

    ERIC Educational Resources Information Center

    Pearson, Sarah

    2016-01-01

    Instructional coaching is an increasingly recognized form of professional development for maintaining teachers' skills. However, little attention has been paid to whether use of a coach is related to teacher self-efficacy, as theorized by Bandura and Tschannen-Moran and McMaster. This study sought to determine if there was a relationship between…

  10. Training an Aging Work Force.

    ERIC Educational Resources Information Center

    Allen, Annamary Zappia

    This manual provides information and suggestions on training the increasingly older work force. An introduction addresses a needed emphasis on training programs to retain older workers as employees and development of effective training that focuses on needs and limitations of older adults as learners. It introduces McDonald's McMaster's Program,…

  11. Using Communities of Practice to Foster Faculty Development in Higher Education

    ERIC Educational Resources Information Center

    Teeter, Christopher; Fenton, Nancy; Nicholson, Karen; Flynn, Terry; Kim, Joseph; McKay, Muriel; O'Shaughnessy, Bridget; Vajoczki, Sue

    2011-01-01

    Communities of practice are becoming more widespread within higher education, yet little research has explored how these social learning networks can enhance faculty development. The focus of this paper is to describe the first-year experience of a community of practice initiative at McMaster University that was designed to engage groups of…

  12. Using Digital Technology to See Angles from Different Angles. Part 1: Corners

    ERIC Educational Resources Information Center

    Host, Erin; Baynham, Emily; McMaster, Heather

    2014-01-01

    In Part 1 of their article, Erin Host, Emily Baynham and Heather McMaster use a combination of digital technology and concrete materials to explore the concept of "corners". They provide a practical, easy to follow sequence of activities that builds on students' understandings. [For "Using Digital Technology to See Angles from…

  13. The Effect of Aromatherapy Massage on Knee Pain and Functional Status in Participants with Osteoarthritis.

    PubMed

    Efe Arslan, Dilek; Kutlutürkan, Sevinç; Korkmaz, Murat

    2018-03-05

    This study was conducted to evaluate the effect of aromatherapy massage on knee pain and functional status in subjects with osteoarthritis. The study was designed as a non-randomized interventional study. The study was carried out on patients who referred to the outpatient clinics of the Department of Orthopedics, Physiotherapy and Rehabilitation at Bozok University Research and Application Hospital, and were diagnosed with osteoarthritis. A total number of 95 patients were included in the study, and of those, 33 were allocated to aromatherapy massage group, 30 were allocated to conventional massage group, and 32 were allocated to the control group. The study data were collected using the Patient Identification Form, visual analogue scale, the Western Ontario and McMaster University Osteoarthritis Index. Repeated measures analysis of variance test was used to analyze the outcomes in the aromatherapy, conventional massage and control groups, according to the weeks of follow-up. Bonferroni test was used for further analysis. Baseline mean visual analogue scale score and the Western Ontario and McMaster University Osteoarthritis Index were not significantly different between the groups (p > .05). Visual analogue scale (rest-activity) scores and the scores in the Western Ontario and McMaster University Osteoarthritis Index in the aromatherapy massage group were lower, and the difference compared to the control group was statistically significant (p < .001). Aromatherapy massage performed in patients with osteoarthritis reduced knee pain scores, decreased morning stiffness, and improved physical functioning status. Thus, as long as specific training is provided for aromatherapy massage, aromatherapy can be recommended for routine use in physical therapy units, hospitals and homes. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  14. Family medicine residents’ practice intentions

    PubMed Central

    Grierson, Lawrence E.M.; Fowler, Nancy; Kwan, Matthew Y.W.

    2015-01-01

    Abstract Objective To assess residents’ practice intentions since the introduction of the College of Family Physicians of Canada’s Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. Design A survey based on Ajzen’s theory of planned behaviour was administered on 2 occasions. Setting McMaster University in Hamilton, Ont. Participants Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. Main outcome measures The survey was modeled so as to measure the respondents’ intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. Results The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents’ intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. Conclusion The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University. PMID:26889508

  15. Alberta Learning: Early Development Instrument Pilot Project Evaluation.

    ERIC Educational Resources Information Center

    Meaney, Wanda; Harris-Lorenze, Elayne

    The Early Development Instrument (EDI) was designed by McMaster University to measure the outcomes of childrens early years as they influence their readiness to learn at school. The EDI was piloted in several Canadian cities in recent years through two national initiatives. Building on these initiatives, Alberta Learning piloted the EDI as a…

  16. Correlations between commonly used clinical outcome scales and patient satisfaction after total knee arthroplasty.

    PubMed

    Kwon, Sae Kwang; Kang, Yeon Gwi; Kim, Sung Ju; Chang, Chong Bum; Seong, Sang Cheol; Kim, Tae Kyun

    2010-10-01

    Patient satisfaction is becoming increasingly important as a crucial outcome measure for total knee arthroplasty. We aimed to determine how well commonly used clinical outcome scales correlate with patient satisfaction after total knee arthroplasty. In particular, we sought to determine whether patient satisfaction correlates better with absolute postoperative scores or preoperative to 12-month postoperative changes. Patient satisfaction was evaluated using 4 grades (enthusiastic, satisfied, noncommittal, and disappointed) for 438 replaced knees that were followed for longer than 1 year. Outcomes scales used the American Knee Society, Western Ontario McMaster University Osteoarthritis Index scales, and Short Form-36 scores. Correlation analyses were performed to investigate the relation between patient satisfaction and the 2 different aspects of the outcome scales: postoperative scores evaluated at latest follow-ups and preoperative to postoperative changes. The Western Ontario McMaster University Osteoarthritis Index scales function score was most strongly correlated with satisfaction (correlation coefficient=0.45). Absolute postoperative scores were better correlated with satisfaction than the preoperative to postoperative changes for all scales. Level IV (retrospective case series). Copyright © 2010 Elsevier Inc. All rights reserved.

  17. How discriminating are discriminative instruments?

    PubMed

    Hankins, Matthew

    2008-05-27

    The McMaster framework introduced by Kirshner & Guyatt is the dominant paradigm for the development of measures of health status and health-related quality of life (HRQL). The framework defines the functions of such instruments as evaluative, predictive or discriminative. Evaluative instruments are required to be sensitive to change (responsiveness), but there is no corresponding index of the degree to which discriminative instruments are sensitive to cross-sectional differences. This paper argues that indices of validity and reliability are not sufficient to demonstrate that a discriminative instrument performs its function of discriminating between individuals, and that the McMaster framework would be augmented by the addition of a separate index of discrimination. The coefficient proposed by Ferguson (Delta) is easily adapted to HRQL instruments and is a direct, non-parametric index of the degree to which an instrument distinguishes between individuals. While Delta should prove useful in the development and evaluation of discriminative instruments, further research is required to elucidate the relationship between the measurement properties of discrimination, reliability and responsiveness.

  18. Inquiry Learning: Level, Discipline, Class Size, What Matters?

    ERIC Educational Resources Information Center

    Vajoczki, Susan; Watt, Susan; Vine, Michelle M.; Liao, Xueqing

    2011-01-01

    Inquiry learning is a pedagogical approach that focuses on the processes and skills required to conduct research. It is a pedagogical approach that has been demonstrated to have positive learning outcomes. McMaster University has been committed to this form of learning for more than ten years in three of the faculties on campus (i.e., Humanities,…

  19. Performance and Analysis of Vortex Oxidizer Injection in a Hybrid Rocket

    DTIC Science & Technology

    2009-05-05

    Braid for Gas Service SS Fem Fittings, SS Hose , 2’L, 1/4" ID McMaster Number: 5665K32 Maximum Pressure: 4250 psi @ 72° F Operating Temperature...Figure J. 9 Type T (328 to 700 F) Thermocouple Probe J.7 Flexible Hydraulic Tubing Extreme Temperature Stainless Steel Hose with Stainless Steel Wire

  20. Collaboratively Evaluating and Deploying Smart Technology in Classrooms

    ERIC Educational Resources Information Center

    Strong, Bart; Kidney, David

    2004-01-01

    For several years prior to 2000, students and faculty at McMaster University rated classrooms below those at peer universities. In the case of many classrooms, the teaching environments were outdated and the technology was old. The provost determined in 2000 that they needed to make a long-term investment in their learning spaces. For sound…

  1. Scholarship in Teaching and Learning: An Interview with John Mitterer

    ERIC Educational Resources Information Center

    Daniel, David B.

    2009-01-01

    John Mitterer earned his PhD in cognitive psychology from McMaster University. Like many teaching professors, his career took an unexpected turn early on when he was hired to teach introductory psychology at Brock University, near Niagara Falls, in Ontario, Canada. It was love at first lecture. He never left the course and now, as a full professor…

  2. Comparison of fecal egg counting methods in four livestock species.

    PubMed

    Paras, Kelsey L; George, Melissa M; Vidyashankar, Anand N; Kaplan, Ray M

    2018-06-15

    Gastrointestinal nematode parasites are important pathogens of all domesticated livestock species. Fecal egg counts (FEC) are routinely used for evaluating anthelmintic efficacy and for making targeted anthelmintic treatment decisions. Numerous FEC techniques exist and vary in precision and accuracy. These performance characteristics are especially important when performing fecal egg count reduction tests (FECRT). The objective of this study was to compare the accuracy and precision of three commonly used FEC methods and determine if differences existed among livestock species. In this study, we evaluated the modified-Wisconsin, 3-chamber (high-sensitivity) McMaster, and Mini-FLOTAC methods in cattle, sheep, horses, and llamas in three phases. In the first phase, we performed an egg-spiking study to assess the egg recovery rate and accuracy of the different FEC methods. In the second phase, we examined clinical samples from four different livestock species and completed multiple replicate FEC using each method. In the last phase, we assessed the cheesecloth straining step as a potential source of egg loss. In the egg-spiking study, the Mini-FLOTAC recovered 70.9% of the eggs, which was significantly higher than either the McMaster (P = 0.002) or Wisconsin (P = 0.002). In the clinical samples from ruminants, Mini-FLOTAC consistently yielded the highest EPG, revealing a significantly higher level of egg recovery (P < 0.0001). For horses and llamas, both McMaster and Mini-FLOTAC yielded significantly higher EPG than Wisconsin (P < 0.0001, P < 0.0001, P < 0.001, and P = 0.024). Mini-FLOTAC was the most accurate method and was the most precise test for both species of ruminants. The Wisconsin method was the most precise for horses and McMaster was more precise for llama samples. We compared the Wisconsin and Mini-FLOTAC methods using a modified technique where both methods were performed using either the Mini-FLOTAC sieve or cheesecloth. The

  3. Predicting international medical graduate success on college certification examinations

    PubMed Central

    Schabort, Inge; Mercuri, Mathew; Grierson, Lawrence E.M.

    2014-01-01

    Abstract Objective To determine predictors of international medical graduate (IMG) success in accordance with the priorities highlighted by the Thomson and Cohl judicial report on IMG selection. Design Retrospective assessment using regression analyses to compare the information available at the time of resident selection with those trainees’ national certification examination outcomes. Setting McMaster University in Hamilton, Ont. Participants McMaster University IMG residents who completed the program between 2005 and 2011. Main outcome measures Associations between IMG professional experience or demographic characteristics and examination outcomes. Results The analyses revealed that country of study and performance on the Medical Council of Canada Evaluating Examination are among the predictors of performance on the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada certification examinations. Of interest, the analyses also suggest discipline-specific relationships between previous professional experience and examination success. Conclusion This work presents a useful technique for further improving our understanding of the performance of IMGs on certification examinations in North America, encourages similar interinstitutional analyses, and provides a foundation for the development of tools to assist with IMG education. PMID:25316762

  4. The application of artificial intelligent techniques to accelerator operations at McMaster University

    NASA Astrophysics Data System (ADS)

    Poehlman, W. F. S.; Garland, Wm. J.; Stark, J. W.

    1993-06-01

    In an era of downsizing and a limited pool of skilled accelerator personnel from which to draw replacements for an aging workforce, the impetus to integrate intelligent computer automation into the accelerator operator's repertoire is strong. However, successful deployment of an "Operator's Companion" is not trivial. Both graphical and human factors need to be recognized as critical areas that require extra care when formulating the Companion. They include interactive graphical user's interface that mimics, for the operator, familiar accelerator controls; knowledge of acquisition phases during development must acknowledge the expert's mental model of machine operation; and automated operations must be seen as improvements to the operator's environment rather than threats of ultimate replacement. Experiences with the PACES Accelerator Operator Companion developed at two sites over the past three years are related and graphical examples are given. The scale of the work involves multi-computer control of various start-up/shutdown and tuning procedures for Model FN and KN Van de Graaff accelerators. The response from licensing agencies has been encouraging.

  5. Assessing and adjusting for non response in the Millennium Cohort Family Study (Open Access Publisher’s Version)

    DTIC Science & Technology

    2017-01-28

    missingness was positively correlated across variables, as evidenced by the much greater spousal response for service members complet- ing the entire survey ...Mike Battaglia1, Hope Seib McMaster2,3 and Valerie A. Stander2 Abstract Background: In conducting population-based surveys , it is important to...reporting findings. This paper examines factors contributing to second stage survey non-response during the baseline data collection for the

  6. A Deep Learning Method to Automatically Identify Reports of Scientifically Rigorous Clinical Research from the Biomedical Literature: Comparative Analytic Study.

    PubMed

    Del Fiol, Guilherme; Michelson, Matthew; Iorio, Alfonso; Cotoi, Chris; Haynes, R Brian

    2018-06-25

    A major barrier to the practice of evidence-based medicine is efficiently finding scientifically sound studies on a given clinical topic. To investigate a deep learning approach to retrieve scientifically sound treatment studies from the biomedical literature. We trained a Convolutional Neural Network using a noisy dataset of 403,216 PubMed citations with title and abstract as features. The deep learning model was compared with state-of-the-art search filters, such as PubMed's Clinical Query Broad treatment filter, McMaster's textword search strategy (no Medical Subject Heading, MeSH, terms), and Clinical Query Balanced treatment filter. A previously annotated dataset (Clinical Hedges) was used as the gold standard. The deep learning model obtained significantly lower recall than the Clinical Queries Broad treatment filter (96.9% vs 98.4%; P<.001); and equivalent recall to McMaster's textword search (96.9% vs 97.1%; P=.57) and Clinical Queries Balanced filter (96.9% vs 97.0%; P=.63). Deep learning obtained significantly higher precision than the Clinical Queries Broad filter (34.6% vs 22.4%; P<.001) and McMaster's textword search (34.6% vs 11.8%; P<.001), but was significantly lower than the Clinical Queries Balanced filter (34.6% vs 40.9%; P<.001). Deep learning performed well compared to state-of-the-art search filters, especially when citations were not indexed. Unlike previous machine learning approaches, the proposed deep learning model does not require feature engineering, or time-sensitive or proprietary features, such as MeSH terms and bibliometrics. Deep learning is a promising approach to identifying reports of scientifically rigorous clinical research. Further work is needed to optimize the deep learning model and to assess generalizability to other areas, such as diagnosis, etiology, and prognosis. ©Guilherme Del Fiol, Matthew Michelson, Alfonso Iorio, Chris Cotoi, R Brian Haynes. Originally published in the Journal of Medical Internet Research (http

  7. Lessons in Adaptability and Preparing for Black Swan Risks from the Military and Hedge Funds

    DTIC Science & Technology

    2014-06-01

    have a lot of other functions too, but you should wake up every morning and think about ‘is this place built to take everything’?”  Warren Buffet ...of inherent human and organizational resistance to change? 1 Warren Buffett, interviewed on FoxBusiness.com, January 2010. 2 Donald Rumsfeld...replenish the capital in their intellectual accounts in preparation for future challenging leadership roles. General H. R. McMaster, a recognized

  8. Tissue Specific Activation and Inactivation of the Neu Proto-Oncogene in Transgenic Mice Using Cre Recombinase

    DTIC Science & Technology

    2000-10-01

    UNCLASSIFIED AD NUMBER ADB264584 NEW LIMITATION CHANGE TO Approved for public release, distribution unlimited FROM Distribution authorized to U.S...MAY RELATE TO THEM. LIMITED RIGHTS LEGEND Award Number: DAMD17-99-1-9285 Organization: McMaster University Those portions of the technical data...contained in this report marked as limited rights data shall not, without the written permission of the above contractor, be (a) released or disclosed outside

  9. Synthesis and Structural Characterization of New Light Molecular Weight Inorganic Oxidizers and Related Derivatives. Volume: 2

    DTIC Science & Technology

    1993-02-01

    of the strong inductive effect of the five fluorine ligands attached to the tellurium atom. 34 It is prepared under anhydrous conditions according to...MOLECULAR WEIGHT INORGANIC OXIDIZERS AND RELATED DERIVATIVES. VOLUME: II Professor G. J. Schrobilgen McMaster University Department of Chemistry...C: F04611-91-K-0004 Molecular Weight Inorganic Oxidizers and Relative PE: 62302F SDerivatives: Volume II 1PR: 5730 6. AUTHOFR(S) TA: 0*( C

  10. Annals of the New York Academy of Sciences. Volume 423. Timing and Time Perception Held at New York on 10-13 May 1983,

    DTIC Science & Technology

    1984-05-13

    PART L TIME PERCEPTION Introduction JOHN GIBBON W. New York State Psychiatric Institute New York, New York 10032; and Department of Psychology ...34."’ Columbia University New York, New York 10027 LORRAINE ALLAN Department of Psychology McMaster University Hamilton, Ontario, Canada LAS 4Ki The study...of timing and time perception has a venerable dual history in experimental psychology . Animal psychologists studying learning and conditioning have

  11. Flight Software Development for the Liberdade Flying Wing Glider

    DTIC Science & Technology

    2013-12-24

    gliders. Bigger gliders are more efficient at horizontal transport. Surveys of natural and man-made flyers ( McMasters , 1974) confirm this relation...The other benefit of a large wing area is that it reduces the coefficient of lift and the associated induced drag (the largest component of drag at...greater reduction in specific energy consumption than does a proportionally smaller lift coefficient . Increases in aspect ratio, in turn, must be

  12. Therapeutic efficacy of three hyaluronic acid formulations in young and middle-aged patients with early-stage meniscal injuries

    PubMed Central

    Dernek, Bahar; Kesiktas, Fatma Nur; Duymus, Tahir Mutlu; Diracoglu, Demirhan; Aksoy, Cihan

    2017-01-01

    [Purpose] To investigate and compare the efficacy of three hyaluronic acid formulations in patients with early-stage meniscal injuries. [Subjects and Methods] Male and female patients who were admitted to our clinic between January 2013 and December 2013, diagnosed with early-stage meniscus lesions of the knee, and given a hyaluronic acid treatment were included in this retrospective study. Patients were categorized into 3 groups according to their treatments: MONOVISC, OSTENIL PLUS, or ORTHOVISC. Scores from a Visual Analog Scale and the Western Ontario and McMaster Universities Arthritis Index were evaluated at baseline and one, three, and six months after baseline. [Results] A total of 55 patients were included in this study. Most of the patients were female (55%), and the mean age of the patients was 42.4 (± 8.1) years. Based on the pre- and post-injection data, there was significant reductions both in the Visual Analog Scale score and the Western Ontario and McMaster Universities Arthritis Index score after the injections for all groups. According to intergroup comparisons, no significant difference was observed in terms of efficacy. [Conclusion] Three hyaluronic acid formulations produced a similar efficacy in patients with meniscal injuries, and further studies are needed to evaluate long-term results. PMID:28744035

  13. Surgical dislocation of the hip and the management of femoroacetabular impingement: results of the Christchurch experience.

    PubMed

    Kempthorne, Joshua T; Armour, Paul C; Rietveld, John A; Hooper, Gary J

    2011-06-01

    Surgical dislocation of the hip has been developed to deal with the problems causing femoroacetabular impingement (FAI). This is a relatively recent procedure that was historically reserved for larger areas specializing in hip surgery. We hypothesized that surgical dislocation can be used for symptomatic FAI in a typical Australasian tertiary orthopaedic centre with acceptable results. This prospective study reviews the results of 53 surgical dislocations in this setting, looking particularly at functional outcomes and early complications. There were significant improvements in the Western Ontario and McMaster University Osteoarthritis Index score at 1, 2, 3 and 4 years post-operatively. Western Ontario and McMaster University Osteoarthritis Index scores increased by 23, 28, 34 and 35 points, respectively (P 0.0039). There was no significant improvement in hip range of motion. There were two (4%) early failures with conversion to total hip arthroplasty, and no cases of post-operative avascular necrosis of the femoral head. We believe that as the diagnosis of FAI and conservative nonarthroplasty surgery of the hip gains wider acceptance, it will become a procedure that should be offered to all appropriate patients in an attempt to delay or limit total hip arthroplasty in this young age group.

  14. Gigabit Network Communications Research

    DTIC Science & Technology

    1992-12-31

    additional BPF channels, raw bytesync support for video codecs, and others. All source file modifications were logged with RCS. Source and object trees were...34 (RFCs). 20 RFCs were published this quarter: RFC 1366: Gerich, E., " Guidelines for Management of IP Address Space", Merit, October 1992. RFC 1367...Topolcic, C., "Schedule for IP Address Space Management Guidelines ", CNRI, October 1992. RFC 1368: McMaster, D. (Synoptics Communications, Inc.), K

  15. Experimental Studies in a Reconfigurable C4 Test-bed for Network Enabled Capability

    DTIC Science & Technology

    2006-06-01

    Cross1, Dr R. Houghton1, and Mr R. McMaster1 Defence Technology Centre for Human factors Integration (DTC HFI ) BITlab, School of Engineering and Design...NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Defence Technology Centre for Human factors Integration (DTC HFI ) BITlab, School of...studies into NEC by the Human Factors Integration Defence Technology Centre ( HFI -DTC). DEVELOPMENT OF THE TESTBED In brief, the C4 test-bed

  16. Catalysis by Single Atoms: Water Gas Shift and Ethylene Hydrogenation

    DTIC Science & Technology

    2009-04-20

    addition to other microscopic phenomena at region of coefficients . Silicon carbide has a higher loss tangent at 2.4 GHz than most ceramics, and thus...Si 50 35 30 20 Ni 50 — — D. Sample holder and preparation: * The remainder is ZrB2. Graphite sheet ( McMaster -Carr, USA) is cut into different...results. 19 B. Microwave hybrid processing i. Microwave heating: 1. Volumetric Microwave absorption is proportional to the loss

  17. Application of a New Grain-Based Reconstruction Algorithm to Microtomography Images for Quantitative Characterization and Flow Modeling

    DTIC Science & Technology

    2008-06-01

    mapping the X-ray absorption through the sample. The amount of absorption depends on the chemical composition and structure of the material and the X...obtained by measuring the X-ray attenua- tion coefficients of the sample at different angles as the sample is rotated about the vertical axis. These... McMaster University, Hamilton, Ontario, Canada. Allen H. Reed is a geologist with the Naval Research Laboratory. His research interests are in marine

  18. Meeting Professional Competencies through Specialized Distance Education: The McMaster University Addiction Studies Program

    ERIC Educational Resources Information Center

    Csiernik, Rick; McGaghran, Christie

    2013-01-01

    Historically, addiction has been an area in which Canadian social workers have received limited formal education. This reality led to the development of 18 core technical competencies through the auspices of the Canadian Centre on Substance Abuse in 2006. A survey of Canadian schools and faculties of social work found that social work students…

  19. Manual and manipulative therapy in addition to rehabilitation for osteoarthritis of the knee: assessor-blind randomized pilot trial.

    PubMed

    Dwyer, Lauren; Parkin-Smith, Gregory F; Brantingham, James W; Korporaal, Charmaine; Cassa, Tammy K; Globe, Gary; Bonnefin, Debra; Tong, Victor

    2015-01-01

    The purpose of this study was to examine the methodological integrity, sample size requirements, and short-term preliminary clinical outcomes of manual and manipulative therapy (MMT) in addition to a rehabilitation program for symptomatic knee osteoarthritis (OA). This was a pilot study of an assessor-blinded, randomized, parallel-group trial in 2 independent university-based outpatient clinics. Participants with knee OA were randomized to 3 groups: 6 MMT sessions alone, training in rehabilitation followed by a home rehabilitation program alone, or MMT plus the same rehabilitation program, respectively. Six MMT treatment sessions (provided by a chiropractic intern under supervision or by an experienced chiropractor) were provided to participants over the 4-week treatment period. The primary outcome was a description of the research methodology and sample size estimation for a confirmatory study. The secondary outcome was the short-term preliminary clinical outcomes. Data were collected at baseline and 5weeks using the Western Ontario and McMasters Osteoarthritis Index questionnaire, goniometry for knee flexion/extension, and the McMaster Overall Therapy Effectiveness inventory. Analysis of variance was used to compare differences between groups. Eighty-three patients were randomly allocated to 1 of the 3 groups (27, 28, and 28, respectively). Despite 5 dropouts, the data from 78 participants were available for analysis with 10% of scores missing. A minimum of 462 patients is required for a confirmatory 3-arm trial including the respective interventions, accounting for cluster effects and a 20% dropout rate. Statistically significant and clinically meaningful changes in scores from baseline to week 5 were found for all groups for the Western Ontario and McMasters Osteoarthritis Index (P ≤ .008), with a greater change in scores for MMT and MMT plus rehabilitation. Between-group comparison did not reveal statistically significant differences between group scores at

  20. Emergency Food Delivery: A State-of-the-Art Assessment

    DTIC Science & Technology

    1987-09-01

    category are prescriptive in nature and are intended to support national preparedness (Billheimer et al . 1978; FEMA 1980b, 1983a, 1985b; Sullivan 1979...existing offices at the state and local levels (Billheimer et al . 1978, USDA 1983). The fact that the state and local USDA offices have ongoing and well...Ellis 1974, FEMA 1980b, Friesema 1979, Greene et al . 1979, Katz 1982, McMasters 1978). 3-20 There may be exceptions to this conclusion. For example

  1. Knightsat Flight Design Review

    DTIC Science & Technology

    2007-08-03

    spring loaded hinges were obtained from McMaster under part number 15205A42. The fasteners used to attach each shutter to its corresponding hinge were... Coefficient of thermal expansion) is fairly well matched to the cell’s germanium substrate. Copper is not a good choice since it expands and contracts...Temperature: K Ground Station Transmission Line Temp.: 290 K Ground Station Sky Temperature: 450 K G.S. Transmission Line Coefficient : 0.7943 Ground Station

  2. Nanocomposite Interphases for Improved Transparent Polymer Composite Materials

    DTIC Science & Technology

    2008-08-01

    intensity of the incident light, A is the attenuation coefficient , and t is the part thickness. The intensity attenuation coefficient is a function of...index that is fairly close to that of fused silica. Most importantly, it has a high thermo- optic coefficient , dn/dt, which results in a large change in...35765K164, McMaster -Carr, Robbinsville, NJ) were attached on the outer side of both aluminum plates as shown, and the temperature was controlled

  3. The effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis.

    PubMed

    Lee, Ji-Hyun; Lee, Sangyong; Choi, SeokJoo; Choi, Yoon-Hee; Lee, Kwansub

    2017-03-01

    [Purpose] The purpose of this study was to identify the effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis. [Subjects and Methods] Twenty patients with degenerative knee arthritis were divided into a conservative physical therapy group (n=10) and an extracorporeal shock wave therapy group (n=10). Both groups received general conservative physical therapy, and the extracorporeal shock wave therapy was additionally treated with extracorporeal shock wave therapy after receiving conservative physical therapy. Both groups were treated three times a week over a four-week period. The visual analogue scale was used to evaluate pain in the knee joints of the subjects, and the Korean Western Ontario and McMaster Universities Osteoarthritis Index was used to evaluate the function of the subjects. [Results] The comparison of the visual analogue scale and Korean Western Ontario and McMaster Universities Osteoarthritis Index scores within each group before and after the treatment showed statistically significant declines in scores in both the conservative physical therapy group and extracorporeal shock wave therapy group. A group comparison after the treatment showed statistically significant differences in these scores in the extracorporeal shock wave therapy group and the conservative physical therapy group. [Conclusion] extracorporeal shock wave therapy may be a useful nonsurgical intervention for reducing the pain of patients with degenerative knee arthritis and improving these patients' function.

  4. Critical Review and Technology Assessments, 󈨟-󈨠

    DTIC Science & Technology

    1991-09-01

    EUTELCIC ALLOY 3. Pages 406-409 890900 WATER SORPTION IN EPOXY THIN FILMS MCMASTER, M.G. UC, ,ERKELEY.CA) TRANSACTIONS. 89.22 SOANE, Di. ,EEEJHMT. Vol...NATION, 21 228-002 PENETRATION THROUGH PFA TUBING AND Vol. S, No. 2, Pags ANTISTATIC PFATUBING 22-28 THIS COLUMN FOCUSES ON A STUIDY OF PFA AND...ANTISTATIC WFA TURING (SUPPLIED BY GALnlEK CORPORATION. CHAS•K MN). THE A.NTISATIC PFA .MATERIAL USED HAS A SURFACE RESISTIVIrY OF lOTO THE ELEVENTH POWER -10

  5. Japan’s Strategic Future: Coalition Operations

    DTIC Science & Technology

    2004-03-01

    34thank-you" to Michael T. McMaster, CDR, USN (Ret.) for his tireless dedication in reading numerous drafts of this thesis in order to create...Institute, Professor Schoppa spoke on this topic at FPRI’s History Institute on Teaching About Japan, October 19-22, 2003. 15 the alliance with the United...all the amenities of home including a gym, internet café, library, and of course a karaoke bar. All JSDF personnel will be confined to the camp

  6. Combining Multiple Types of Intelligence to Generate Probability Maps of Moving Targets

    DTIC Science & Technology

    2013-09-01

    normalization coefficient k similar to Demspter-Shafer’s combination rule. d. Mass Mean This rule of combination is the most straightforward one... coefficient , we can state that without normalizing, the updated distribution is: fupdate t   qk k t M 1 qk n k t M        (3.3) 36...Lawrence, KS. Chen, Z. (2003). Bayesian filtering: From Kalman filters to particle filters and beyond. Technical report, McMaster University. Dempster

  7. Portable Fiber Laser System and Method to Remove Pits and Cracks on Sensitized Surfaces of Aluminum Alloys

    DTIC Science & Technology

    2015-08-01

    resistant 5083- H116 aluminum, sheet, 1/4" thick, 2" x 24", 2 pieces 71.60 5 Reagent VWR & Fisher Nitric acid and sodium hydroxide for mass loss...Temperature stability ±0.1oC @37oC Temperature uniformity ±0.2oC @37oC 693.55 4 5083-H116 Al-Mg alloy materials McMaster Carr Strengthened corrosion ...test, other acids for etching, electrochemical polishing, and anodizing 700.28 6 Containers VWR Beakers, petri dishes, bottles, graduated cylinders

  8. Naval Aviation IMA Repair Capability: A Readiness to Resources Approach.

    DTIC Science & Technology

    1983-12-01

    systems commands and offices. 3, .-. e , No. cFE 0000 CP15PATL OR BMS REouWE gKIATRE_ woms CENTIP KEOscu. coNTiO.mI AMoCES COPYw co 5( US &Lp6J4 PE PM3K...U December 1983 " Thesis Advisor: A. W. McMasters Approved for public release; distribution unlimited. 4𔃺 8 4 04 25 069 -* ,** *- a’’ e ...29 2. Maintenance/Supply InterrelationshiDs ------ 32 E . MAINTENANCE DATA SYSTEM ------------------------- 33 IV. PLANNING "I" LEVEL

  9. Peace through health II: a framework for medical student education.

    PubMed

    Arya, Neil

    2004-01-01

    The world's first university course in Peace through Health (PtH) recently finished at McMaster University, Hamilton, Canada. Medical students and academic staff in Canada and Europe have expressed interest in developing this course for other medical schools. Seven medical students were selected to do an unofficial 'audit' in return for 'in kind' work, developing the course materials for the web and adaptation to the medical curriculum. This article sets out the goals and structure of the course as a guide for similar teaching models.

  10. Email Between Patient and Provider: Assessing the Attitudes and Perspectives of 624 Primary Health Care Patients.

    PubMed

    Seth, Puneet; Abu-Abed, Mohamed Ismail; Kapoor, Vikram; Nicholson, Kathryn; Agarwal, Gina

    2016-12-22

    Email between patients and their health care providers can serve as a continuous and collaborative forum to improve access to care, enhance convenience of communication, reduce administrative costs and missed appointments, and improve satisfaction with the patient-provider relationship. The main objective of this study was to investigate the attitudes of patients aged 16 years and older toward receiving email communication for health-related purposes from an academic inner-city family health team in Southern Ontario. In addition to exploring the proportion of patients with a functioning email address and interest in email communication with their health care provider, we also examined patient-level predictors of interest in email communication. A cross-sectional study was conducted using a self-administered, 1-page survey of attitudes toward electronic communication for health purposes. Participants were recruited from attending patients at the McMaster Family Practice in Hamilton, Ontario, Canada. These patients were aged 16 years and older and were approached consecutively to complete the self-administered survey (N=624). Descriptive analyses were conducted using the Pearson chi-square test to examine correlations between variables. A logistic regression analysis was conducted to determine statistically significant predictors of interest in email communication (yes or no). The majority of respondents (73.2%, 457/624) reported that they would be willing to have their health care provider (from the McMaster Family Practice) contact them via email to communicate health-related information. Those respondents who checked their personal email more frequently were less likely to want to engage in this electronic communication. Among respondents who check their email less frequently (fewer than every 3 days), 46% (37/81) preferred to communicate with the McMaster Family Practice via email. Online applications, including email, are emerging as a viable avenue for patient

  11. Comparison of photon attenuation coefficients (2-150 KeV) for diagnostic imaging simulations

    NASA Astrophysics Data System (ADS)

    Dodge, Charles W., III; Flynn, Michael J.

    2004-05-01

    The Radiology Research Laboratory at the Henry Ford Hospital has been involved in modeling x-ray units in order to predict image quality. A critical part of that modeling process is the accurate choice of interaction coefficients. This paper serves as a review and comparison of existing interaction models. Our objective was to obtain accurate and easily calculated interaction coefficients, at diagnostically relevant energies. We obtained data from: McMaster, Lawrence Berkeley Lab data (LBL), XCOM and FFAST Data from NIST, and the EPDL-97 database via LLNL. Our studies involve low energy photons; therefore, comparisons were limited to Coherent (Rayleigh), Incoherent (Compton) and Photoelectric effects, which were summed to determine a total interaction cross section. Without measured data, it becomes difficult to definitively choose the most accurate method. However, known limitations in the McMaster data and smoothing of photo-edge transitions can be used as a guide to establish more valid approaches. Each method was compared to one another graphically and at individual points. We found that agreement between all methods was excellent when away from photo-edges. Near photo-edges and at low energies, most methods were less accurate. Only the Chanter (FFAST) data seems to have consistently and accurately predicted the placement of edges (through M-shell), while minimizing smoothing errors. The EPDL-97 data by LLNL was the best over method in predicting coherent and incoherent cross sections.

  12. Validation of the Italian translation of the Inflammatory Bowel Disease Questionnaire.

    PubMed

    Ciccocioppo, Rachele; Klersy, Catherine; Russo, Maria Luisa; Valli, Monica; Boccaccio, Vincenzo; Imbesi, Venerina; Ardizzone, Sandro; Porro, Gabriele Bianchi; Corazza, Gino Roberto

    2011-07-01

    Health-related quality of life is an important measure of treatment outcome; its evaluation requires the use of internationally validated ad hoc questionnaires. The McMaster Inflammatory Bowel Disease Questionnaire (IBDQ) is the most used specific instrument. To assess the validity and reliability of the Italian translation of the IBDQ. The IBDQ underwent forward and backward translation; 13 patients were enrolled for cognitive testing of the Italian version to increase clarity. For field testing, 113 patients (65 with Crohn's disease and 48 with ulcerative colitis) completed both the IBDQ and the generic instrument 36-item Short Form Health Survey scale (SF-36). Data quality was optimal with high completeness and low floor and ceiling effect. Item internal consistency was satisfied for 100% of patients, while discriminant validity showed a few items with higher correlations with other scales. Cronbach's alpha coefficient was 0.96. Test-retest correlations indicated good reliability (Pearson R 0.81). Exploratory factor analysis indicated that the original grouping of the item was suboptimal. The score proved sensitive to disease activity, gender and quality of life as measured by the SF-36. The Italian translation of the McMaster Inflammatory Bowel Disease Questionnaire sounds natural and is easy to understand. A field test gave results comparable to other international validations, supporting its use in cross-national surveys. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. Increased Range of Motion Is Important for Functional Outcome and Satisfaction After Total Knee Arthroplasty in Asian Patients.

    PubMed

    Ha, Chul-Won; Park, Yong-Beom; Song, Young-Suk; Kim, Jun-Ho; Park, Yong-Geun

    2016-06-01

    Although range of motion (ROM) is considered as an important factor for good outcome after total knee arthroplasty (TKA), the association of the degree of ROM with functional outcome and patient satisfaction is debated. We, therefore, investigated whether increased ROM would affect functional outcome and patient satisfaction after TKA in Asian patients. We reviewed 630 patients who underwent primary TKA with minimum 2-year follow-up. Clinical outcomes were evaluated by Knee Society (KS) score, Western Ontario and McMaster Universities osteoarthritis index, and high-flexion knee score. Patient satisfaction was evaluated using a validated questionnaire. The association of ROM and change in ROM (cROM) with clinical outcomes and satisfaction were analyzed using partial correlation analysis and multiple median regression analysis. All functional scores showed significant correlation with postoperative ROM (r = 0.129, P = .001 in Knee Society score; r = -0.101, P = .012 in Western Ontario and McMaster Universities osteoarthritis index; r = 0.183, P < .001 in high-flexion knee score). cROM correlated with satisfaction (r = 0.192, P = .005). Postoperative ROM and cROM were revealed as predisposing factors affecting function outcome using multivariable regression analysis. cROM was found as a predisposing factor affecting satisfaction. Based on the results of this study, ROM positively associated with functional outcome and cROM positively associated with patient satisfaction after TKA. These findings suggest that increased ROM after TKA is an important factor for functional outcome and satisfaction in Asian patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Do residents in a northern program have better quality lives than their counterparts in a city?

    PubMed Central

    Johnsen, J. H.

    2001-01-01

    OBJECTIVE: To determine whether McMaster University's family medicine residents training in the Family Medicine North (FMN) program have better quality lives than those based in Hamilton, Ont (urban). DESIGN: Residents at both sites were simultaneously given the Quality of Life Questionnaire, a standardized measurement tool. They were asked to complete the questionnaire anonymously and to provide demographic data. SETTING: Family practice residencies in Ontario. PARTICIPANTS: McMaster University's family medicine residents. Of 66 residents living in Hamilton, 36 completed the questionnaire; five respondents were ineligible. Of 25 residents living in Thunder Bay, Ont, 24 completed the questionnaire; none were ineligible. MAIN OUTCOME MEASURES: Total quality-of-life score. Score was divided into five major domains, each with several subdomains: general well-being (material, physical, and personal growth), interpersonal relations (marital, parent-child, extended family, and extramarital), organizational activity (altruistic and political behaviour), occupational activity (job characteristics, occupational relations, and job satisfiers), and leisure and recreational activity (creative/esthetic behaviour, sports activity, vacation behaviour). RESULTS: The FMN residents scored significantly higher than the Hamilton-based residents on overall quality of life (124.7 vs 112.5, P < .05) and tended to score higher in the five major domains. The trend reached statistical significance in general well-being and occupational activity; it was also apparent in various subdomains, with statistically significant differences in material well-being, marital relations, job characteristics, job satisfiers, and vacation behaviour. CONCLUSION: Family Medicine North residents enjoy better quality of life than their urban counterparts based on responses to a standardized questionnaire. PMID:11398733

  15. Validation of the Persian version of the inflammatory bowel disease questionnaire (IBDQ) in ulcerative colitis patients.

    PubMed

    Maleki, Iradj; Taghvaei, Tarang; Barzin, Maryam; Amin, Kamyar; Khalilian, Alireza

    2015-01-01

    Inflammatory bowel diseases (IBD) are a group of inflammatory conditions of the colon and small intestine that may have critical consequences on patient's quality of life (QOL). Many disease-specific QOL tools have been developed recently. The McMaster Inflammatory Bowel Disease Questionnaire (IBDQ) is one of them. The aim of this study was to translate the IBDQ from English to Persian and evaluate the validity and reliability of this version of the McMaster IBDQ. 68 subjects with ulcerative colitis were recruited in this study. The original IBDQ was translated into Persian using back- translation method. The reliability of the subscales and the summary score of the Persian IBDQ was demonstrated by intraclass correlation coefficients, their validity was evaluated by their correlations with SF-36, visual analogue scale and colitis activity index. All dimensions of IBDQ met the standards of construct validity and were correlated well with SF-36, visual analog scale and colitis activity index. IBDQ was able to discriminate the different groups of patients. The intraclass correlation coefficient was very high and its value was close to one (P<0.05). All dimensional scores differed significantly between the baseline and the follow-up measurement. The findings of this study conclude that the Persian translation of IBDQ confers satisfactory psychometric and cultural properties when applied to a sample of Iranian population with inflammatory bowel disease. This questionnaire is recommended for use in clinical trials and in the assessment of efficacy of interventions and therapy.

  16. Three Licentiates of the Royal College of Surgeons of Edinburgh who were decorated with the Victoria Cross.

    PubMed

    Kaufman, M H

    2011-08-01

    Since the Victoria Cross was introduced in January 1856 by Queen Victoria to reward acts of valour in the face of the enemy, initially during the Crimean War, over 1350 medals have been awarded. Of these, three were awarded to medical officers who had previously gained the Licentiate Diploma of the Royal College of Surgeons of Edinburgh (LRCS Edin) - Valentine Munbee McMaster on 25 September 1857, Henry Thomas Sylvester on 20 November 1857 (although the acts of valour for which he was awarded his VC occurred on two occasions in September 1855) and Campbell Mellis (or Millis) Douglas on 7 May 1867.

  17. Evidence-Based Medicine: A Genealogy of the Dominant Science of Medical Education.

    PubMed

    Hanemaayer, Ariane

    2016-12-01

    Debates about how knowledge is made and valued in evidence-based medicine (EBM) have yet to understand what discursive, social, and historical conditions allowed the EBM approach to stabilize and proliferate across western medical education. This paper uses a genealogical approach to examine the epistemological tensions that emerged as a result of various problematizations of uncertainty in medical practice. I explain how the problematization of uncertainty in the literature and the contingency of specific social, political, economic, and historical relations allowed the EBM approach to become a programmatic and pedagogical focus of the Faculty of Medicine at McMaster University and beyond.

  18. Nuclear Data Sheets for A = 21

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Firestone, R.B.

    2015-07-15

    This evaluation of A = 21 has been updated from previous evaluations published in 2004Fi10, 1998En04, 1990En08, and 1978En02. Coverage includes properties of adopted levels and γ-rays, decay-scheme data (energies, intensities and placement of radiations), and cross reference entries. The following tables continue the tradition of showing the systematic relationships between levels in A = 21. Much of the new data in this evaluations were taken directly from the xundl database, compiled under the direction of Balraj Singh, McMaster University. The evaluator is particularly appreciative of the efforts of the xundl compilers.

  19. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Persian Speaking Patients with Knee Osteoarthritis.

    PubMed

    Ebrahimzadeh, Mohammad H; Makhmalbaf, Hadi; Birjandinejad, Ali; Keshtan, Farideh Golhasani; Hoseini, Hosein A; Mazloumi, Seyed Mahdi

    2014-03-01

    Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the WOMAC score that has been translated and adapted into different languages. The purpose of this study was cultural adaptation, validation and reliability testing of the Persian version of the WOMAC index in Iranians with knee osteoarthritis. We translated the original WOMAC questionnaire into Persian by the forward and backward technique, and then its psychometric study was done on 169 native Persian speaking patients with knee degenerative joint disease. Mean age of patients was 53.9 years. The SF-36 and KOOS were used to assess construct validity. Reliability testing resulted in a Cronbach's alpha of 0.917, showing the internal consistency of the questionnaire to be a reliable tool. Inter-correlation matrix among different scales of the Persian WOMAC index yielded a highly significant correlation between all subscales including stiffness, pain, and physical function. In terms of validity, Pearson`s correlation coefficient was significant between three domains of the WOMAC with PF, RP, BP, GH, VT, and PCS dimensions of the SF-36 health survey (P<0.005) and KOOS (P<0.0001) . The Persian WOMAC index is a valid and reliable patient- reported clinical instrument for knee osteoarthritis.

  20. Effects of whole body vibration on pain, stiffness and physical functions in patients with knee osteoarthritis: a systematic review and meta-analysis.

    PubMed

    Wang, Pu; Yang, Xiaotian; Yang, Yonghong; Yang, Lin; Zhou, Yujing; Liu, Chuan; Reinhardt, Jan D; He, Chengqi

    2015-10-01

    To assess the effects of whole body vibration for pain, stiffness and physical functions in patients with knee osteoarthritis. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Physiotherapy Evidence Database (PEDro) and EMBASE (up to October 2014) to identify relevant randomized controlled trials. The outcome measures were pain, stiffness and physical functions. Two investigators identified eligible studies and extracted data independently. The PEDro score was used to evaluate the methodological quality of the selected studies. Standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I(2) test. A total of five randomized controlled trials involving 170 patients with knee osteoarthritis met the inclusion criteria. Only four studies involving 144 patients were deemed to be good quality trials (PEDro score = 6-7). Meta-analysis revealed that whole body vibration has a significant treatment effect in Western Ontario and McMaster Universities index physical function score (SMD = -0.72 points, 95% CI = -1.14 to -0.30, P = 0.0008), 12 weeks whole body vibration improved the 6-minute walk test (SMD 1.15 m, 95% CI 0.50 to 1.80, P = 0.0006) and balance (SMD = -0.78 points, 95% CI -1.40 to -0.16, P = 0.01). Whole body vibration was not associated with a significant reduction in Western Ontario and McMaster Universities index pain and stiffness score. Eight-week and 12-week whole body vibration is beneficial for improving physical functions in patients with knee osteoarthritis and could be included in rehabilitation programs. © The Author(s) 2014.

  1. Functional outcome after successful internal fixation versus salvage arthroplasty of patients with a femoral neck fracture.

    PubMed

    Zielinski, Stephanie M; Keijsers, Noël L; Praet, Stephan F E; Heetveld, Martin J; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; Van Lieshout, Esther M M

    2014-12-01

    To determine patient independency, health-related and disease-specific quality of life (QOL), gait pattern, and muscle strength in patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture. Secondary cohort study to a randomized controlled trial. Multicenter trial in the Netherlands, including 14 academic and nonacademic hospitals. Patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture were studied. A comparison was made with patients who healed uneventfully after internal fixation. None (observatory study). Patient characteristics, SF-12, and Western Ontario McMaster osteoarthritis index scores were collected. Gait parameters were measured using plantar pressure measurement. Maximum isometric forces of the hip muscles were measured using a handheld dynamometer. Differences between the fractured and contralateral leg were calculated. Groups were compared using univariate analysis. Of 248 internal fixation patients (median age, 72 years), salvage arthroplasty was performed in 68 patients (27%). Salvage arthroplasty patients had a significantly lower Western Ontario McMaster osteoarthritis index score (median, 73 vs. 90; P = 0.016) than patients who healed uneventfully after internal fixation. Health-related QOL (SF-12) and patient independency did not differ significantly between the groups. Gait analysis showed a significantly impaired progression of the center of pressure in the salvage surgery patients (median ratio, -8.9 vs. 0.4, P = 0.013) and a significant greater loss of abduction strength (median, -25.4 vs. -20.4 N, P = 0.025). Despite a similar level of dependency and QOL, salvage arthroplasty patients have inferior functional outcome than patients who heal after internal fixation of a femoral neck fracture. Therapeutic level III.

  2. Aromatherapy massage with lavender essential oil and the prevention of disability in ADL in patients with osteoarthritis of the knee: A randomized controlled clinical trial.

    PubMed

    Nasiri, Ahmad; Mahmodi, Mohammad Azim

    2018-02-01

    Knee osteoarthritis is considered as one of the most prevalent musculoskeletal disorders which leads to joint degeneration and consequently disability in activities of daily living. This study aimed to evaluate the effects of aromatherapy massage with lavender essence on activities of daily living of patients with knee osteoarthritis. This is a single-blinded, randomized clinical trial. A total of 90 patients with osteoarthritis of the knee referring to the outpatient rheumatology clinics affiliated to Birjand University of Medical Sciences were selected via convenience sampling method. The participants were randomly assigned into three groups: intervention group (aromatherapy massage with lavender essential oil), placebo group (massage with almond oil) and control group (without massage). The activities of daily living of patients was evaluated according to the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) at baseline, immediately after the intervention, 1 week, and 4 weeks after the intervention. Data were analyzed using SPSS statistical software version 16. The activities of daily living of patients were significantly improved immediately and 1 week after the intervention in the intervention group compared with their initial status (p < .001) and that of the control group (p < .001 and p = .03 respectively). However, 4 weeks after the intervention, there was no significant difference between the groups according to the Western Ontario and McMaster Universities Osteoarthritis index (p = .95). Aromatherapy massage with lavender essential oil may reduce the incidence of activities of daily living disability in patients with osteoarthritis of the knee. However, further studies are required to confirm findings of this study. Copyright © 2017. Published by Elsevier Ltd.

  3. A Randomized Trial Comparing Ceramic-on-Ceramic Bearing vs Ceramic-on-Crossfire-Polyethylene Bearing Surfaces in Total Hip Arthroplasty.

    PubMed

    Beaupre, Lauren A; Al-Houkail, Amro; Johnston, Donald William C

    2016-06-01

    Bearing surfaces in total hip arthroplasty (THA) may affect implant longevity and hence patient outcomes. This randomized clinical trial determined how ceramic-on-ceramic (CERAMIC) bearing THA affected joint-specific pain, function, and stiffness and prosthesis fixation/longevity over 10 postoperative years compared with ceramic-on-highly-crosslinked-polyethylene (POLYETHYLENE) bearing THA. This is a follow-up to previously reported 5-year outcomes. Subjects aged <61 years were randomized to CERAMIC (n = 48) or POLYETHYLENE (n = 44) THA. Subjects were assessed using the Western Ontario McMaster Osteoarthritis Index and the RAND 12-Item Health Survey preoperatively, and at 1, 5, and 10 years postoperatively. Plain radiographs were evaluated at 10 years for fixation, and medical records were reviewed for revisions. Of 92 subjects, 6 (7%) died within 10 years; 68 (79%) survivors provided radiographic and/or clinical follow-up at 10 years postoperatively. Improvements seen at 5 years in both the Western Ontario McMaster Osteoarthritis Index and RAND 12-Item Health Survey were retained at 10 years with no group differences (P > .48). There were no failures or loss of fixation related to bearing surfaces/wear in either group. Over 10 years, 3 subjects in the POLYETHYLENE group had revisions that were related to recurrent dislocation; 2 revisions were performed within 2 years of surgery, and one further subject underwent revision at 7 years postoperatively. This is one of the first randomized clinical trials to examine 10-year outcomes between CERAMIC and POLYETHYLENE bearing THAs. Both bearing surfaces performed well out to 10 years in subjects who were <61 years at time of surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Sentinels in a climatic outpost: Endoparasites in the introduced muskox (Ovibos moschatus wardi) population of Dovrefjell, Norway

    PubMed Central

    Davidson, Rebecca K.; Amundsen, Hanne; Lie, Nora Oftenes; Luyckx, Katrien; Robertson, Lucy J.; Verocai, Guilherme G.; Kutz, Susan J.; Ytrehus, Bjørnar

    2014-01-01

    We assessed the occurrence of endoparasite eggs, cysts, oocysts and larvae in the muskox population of Dovrefjell, Norway, during June and August 2012. This population originates from 13 calves translocated from Eastern Greenland during the 1950s. A total of 167 faecal samples were collected, of which 49% came from identified individuals: 165 were examined by the Baermann and 95 by McMaster techniques and 167 by immunofluorescence antibody test (IFAT). Lungworm larvae recovered in the Baermanns were identified as Protostrongylidae (82%) and Dictyocaulus sp. (76%) based on morphology. Further molecular analyses of the ITS-2 region of two protostrongylid larvae from two muskoxen as Muellerius capillaris. Larval prevalence and intensity differed significantly between samples collected from the different age groups in June and August, with increasing prevalence and intensity in calves during the course of their first summer, whereas intensity decreased in adults from June to August. McMaster test and IFAT were used to determine the occurrence of infections with intestinal strongyles (84%), Moniezia spp. (24%), Nematodirus sp. (2%), Eimeria spp. (98%), Cryptosporidium sp. (14%) and Giardia duodenalis (7%). Molecular analyses of three isolates of Cryptosporidium and Giardia were identified as Cryptosporidium xiaoi and G. duodenalis assemblage A. Although infection intensity of all these intestinal parasites tended to be low, the high level of polyparasitism, together with the other challenges faced by this population living at the edge of their climatic range, means that these infections should not be ignored. The potential that M. capillaris, Cryptosporidium and Giardia infections derive from other sympatric host species (sheep and reindeer) is discussed. PMID:25161914

  5. Selective Medial Release Technique Using the Pie-Crusting Method for Medial Tightness During Primary Total Knee Arthroplasty.

    PubMed

    Ha, Chul-Won; Park, Yong-Beom; Lee, Choong-Hee; Awe, Soo-Ik; Park, Yong-Geun

    2016-05-01

    The pie-crusting method is popular in releasing lateral tightness during primary total knee arthroplasty (TKA) but is not well described for medial release. We established a selective medial release technique using the pie-crusting technique and investigated the effectiveness and safety of the technique during primary TKA. We retrospectively reviewed 729 primary TKAs with varus deformity between October 2009 and June 2012. Medial tightness in flexion was released by traditional subperiosteal stripping for the anterior portion of the medial collateral ligament (aMCL). Medial tightness in extension was released by the pie crusting for the tight fibers in the posterior portion of the MCL and/or posteromedial corner structures (pMCL/PMCS). Clinical outcomes were evaluated by Knee Society (KS) scores and the Western Ontario and McMaster Universities Osteoarthritis Index. Any complications, including late medial instability that may be related to our surgical technique, were carefully inspected. Among the 729 knees, 170 (23.3%) required subperiosteal stripping for balancing in flexion only, 186 (25.5%) required the pie-crusting for balancing in extension only and 142 (19.5%) required subperiosteal stripping and the pie-crusting for balancing in flexion and extension. The KS knee score was improved from 52.5 to 83.4, KS function score from 58.2 to 91.9, and Western Ontario and McMaster Universities Osteoarthritis Index from 42.7 to 21.8 (P < .001, all). No specific complications related to our technique were identified. The selective medial release technique appears to be an effective and safe method to obtain a balanced mediolateral gap in primary TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Analgesic Effect and Functional Improvement Caused by Radiofrequency Treatment of Genicular Nerves in Patients With Advanced Osteoarthritis of the Knee Until 1 Year Following Treatment.

    PubMed

    Santana Pineda, María M; Vanlinthout, Luc E; Moreno Martín, Ana; van Zundert, Jan; Rodriguez Huertas, Fernando; Novalbos Ruiz, José P

    Radiofrequency ablation of genicular nerves has proved to be successful in relieving pain and incapacity caused by osteoarthritis of the knee. However, long-term efficacy of such a treatment remains to be assessed. The current study aimed to reproduce radiofrequency neurotomy of genicular nerves to manage gonarthrosis pain and disability and establish therapeutic response until 1 year after intervention. This single-center, prospective, observational, noncontrolled, longitudinal study included patients with grade 3 to 4 gonarthrosis suffering from intractable knee pain, scoring 5 or more on the visual analog scale (VAS) during >6 months. Therapy was based on ultrasound guided radiofrequency neurotomy of the superior medial, superior lateral and inferior medial genicular nerves. Visual analog scale and Western Ontario and McMaster Universities Osteoarthritis scores were assessed before therapy and at 1, 6, and 12 months following treatment. Radiofrequency neurotomy of genicular nerves significantly reduced perceived pain (VAS) and disability (Western Ontario and McMaster Universities Osteoarthritis) in the majority of participants, without untoward events. The proportion of participants with improvement of 50% or greater in pretreatment VAS scores at 1, 6, and 12 months following intervention were 22/25 (88%), 16/25 (64%) and 8/25 (32%), respectively. Ultrasound-guided radiofrequency neurotomy of genicular nerves alleviates intractable pain and disability in the majority of patients with advanced osteoarthritis of the knee. Such a treatment is safe and minimally invasive and can be performed in an outpatient setting. The beneficial effect of treatment started to decline after 6 months, but even 1 year after the intervention, 32% of patients reported 50% improvement or greater in pretreatment VAS scores.

  7. Automated parasite faecal egg counting using fluorescence labelling, smartphone image capture and computational image analysis.

    PubMed

    Slusarewicz, Paul; Pagano, Stefanie; Mills, Christopher; Popa, Gabriel; Chow, K Martin; Mendenhall, Michael; Rodgers, David W; Nielsen, Martin K

    2016-07-01

    Intestinal parasites are a concern in veterinary medicine worldwide and for human health in the developing world. Infections are identified by microscopic visualisation of parasite eggs in faeces, which is time-consuming, requires technical expertise and is impractical for use on-site. For these reasons, recommendations for parasite surveillance are not widely adopted and parasite control is based on administration of rote prophylactic treatments with anthelmintic drugs. This approach is known to promote anthelmintic resistance, so there is a pronounced need for a convenient egg counting assay to promote good clinical practice. Using a fluorescent chitin-binding protein, we show that this structural carbohydrate is present and accessible in shells of ova of strongyle, ascarid, trichurid and coccidian parasites. Furthermore, we show that a cellular smartphone can be used as an inexpensive device to image fluorescent eggs and, by harnessing the computational power of the phone, to perform image analysis to count the eggs. Strongyle egg counts generated by the smartphone system had a significant linear correlation with manual McMaster counts (R(2)=0.98), but with a significantly lower coefficient of variation (P=0.0177). Furthermore, the system was capable of differentiating equine strongyle and ascarid eggs similar to the McMaster method, but with significantly lower coefficients of variation (P<0.0001). This demonstrates the feasibility of a simple, automated on-site test to detect and/or enumerate parasite eggs in mammalian faeces without the need for a laboratory microscope, and highlights the potential of smartphones as relatively sophisticated, inexpensive and portable medical diagnostic devices. Copyright © 2016 Australian Society for Parasitology. Published by Elsevier Ltd. All rights reserved.

  8. An Analysis of the Advice Codes and Priorities Placed on 2Z Cognizance Requisitions.

    DTIC Science & Technology

    1984-12-01

    for 2Z coo mater i I cin have on fleet support and the mission ca -,abilit , f Ieet- n ts.As the inventory manager for 2Z cogI Matel ia, AV FI.EX s... i st ment in su ticient spares tor p r Ln 1-al Itoms is n , inLed by the NAVCOM PT b dget p oii. T is 74 i.y r ,cstr acts the number p s-Ires th,- i In...Authors: Robert R . Bird LindayJ. Bird Approved by: ali i -. A / Alan W McMasters, T-hesis Advisor Paul M. Carrick, Second Reader Willis R . Greer, Jr

  9. 1999 Horton Research Grants awarded

    NASA Astrophysics Data System (ADS)

    The Horton (Hydrology) Research Grant Committee presented three grants at the 1999 AGU Spring Meeting in Boston, Massachusetts, last June. S. Jean Birks is currently a Ph.D. candidate in the Earth Sciences Department at the University of Waterloo under the supervision of Tom Edwards and Victoria Remenda (Queen's University). The title of her Ph.D. dissertation is “Long-term Natural Tracer Migration in Thick Unfractured Clay: Implications for Reconstructing the Post-glacial Isotopic History of Precipitation from Aquitards in the Northern Great Plains.” Jean received her B.Sc. in geography and environmental science from McMaster University and her M.Sc. in hydrogeology from Queen's University.

  10. Can the academic background of medical graduates be detected during internship?

    PubMed Central

    Woodward, C. A.; McAuley, R. G.

    1983-01-01

    Performance ratings were obtained by the clinical supervisors of four graduated classes of McMaster University medical students during internship. The supervisors detected no difference in performance between the graduates who met the "traditional" admissions criteria (both an undergraduate grade point average of 3.1 or greater on a 4-point scale and previous training in biology, general and organic chemistry, and physics) and those who lacked one or both of these prerequisites. These data suggest that medical schools can expand their admissions criteria without fearing that their graduates will perform less well as interns because of a lack of traditional academic preparation for medical school. PMID:6883258

  11. Gait Parameters and Functional Outcomes After Total Knee Arthroplasty Using Persona Knee System With Cruciate Retaining and Ultracongruent Knee Inserts.

    PubMed

    Rajgopal, Ashok; Aggarwal, Kalpana; Khurana, Anshika; Rao, Arun; Vasdev, Attique; Pandit, Hemant

    2017-01-01

    Total knee arthroplasty is a well-established treatment for managing end-stage symptomatic knee osteoarthritis. Currently, different designs of prostheses are available with majority ensuring similar clinical outcomes. Altered surface geometry is introduced to strive toward gaining superior outcomes. We aimed to investigate any differences in functional outcomes between 2 different polyethylene designs namely the Persona CR (cruciate retaining) and Persona UC (ultracongruent) tibial inserts (Zimmer-Biomet, Warsaw, IN). This prospective single blind, single-surgeon randomized controlled trial reports on 105 patients, (66 female and 39 male), who underwent simultaneous bilateral total knee arthroplasty using the Persona knee system (Zimmer-Biomet) UC inserts in one side and CR inserts in the contralateral side. By a blind assessor, at regular time intervals patients were assessed in terms of function and gait. The functional knee scoring scales used were the Western Ontario and McMaster Universities Osteoarthritis Index and Modified Knee Society Score. The gait parameters evaluated were foot pressure and step length. During the study period, no patient was lost to follow-up or underwent revision surgery for any cause. Western Ontario and McMaster Universities Osteoarthritis Index scores, Modified Knee Society Score, and knee range of motion of all 105 patients assessed preoperatively and postoperatively at 6 months, 1 year, and 2 years showed statistically better results (P < .05) for UC inserts. Gait analysis measuring foot pressures and step length, however, did not show any statistically significant differences at 2-year follow-up. Ultracongruent tibial inserts show significantly better functional outcomes as compared to CR inserts during a 2-year follow-up period. However, in this study these findings were not shown to be attributed to differences in gait parameters. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Clinical improvement of patients with osteoarthritis using thermal mineral water at Szigetvár Spa—results of a randomised double-blind controlled study

    NASA Astrophysics Data System (ADS)

    Hanzel, Adrienn; Horvát, Krisztina; Molics, Bálint; Berényi, Károly; Németh, Balázs; Szendi, Katalin; Varga, Csaba

    2018-02-01

    Since 1966, Szigetvár in Hungary is well recognised as a thermal spa. Many patients suffering from rheumatic diseases are treated with its thermal mineral water. Our objective was to investigate the effects of a 3-week-long outpatient balneotherapy-based rehabilitation program on patients suffering from osteoarthritis of the hips and the knees. During the treatment period, patients received a 30-min underwater jet massage in a bath tub, five times a week. One patient group received jet massage in a bath tub containing mineral water; the other group received the same treatment in tap water. Primary outcomes were measured by range of movement of the involved joints and Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Visual analogue scale (VAS) was applied to measure current severity of pain. Furthermore, quality of life was assessed using the Short Form 36 questionnaire (SF-36). Range of movement (ROM) score, Western Ontario and McMaster University Osteoarthritis Index and visual analogue scale were determined before the first treatment, after the last treatment and 3 months after the last treatment. SF-36 questionnaire was filled in before the first and after the last treatment. Fifty patients (17 male, 33 female mean age 66.7 ± 4.79 years) were enrolled. After randomisation, patients were divided into two groups: tap water n = 24 and mineral water n = 26. Treatment with the thermal mineral water of Szigetvár significantly improved ROM, WOMAC scores, and SF-36-scored quality of life of the patients. Our double-blind study provided evidence for the beneficial health effects of another Hungarian thermal mineral water masking the colour, odour and pH of the tap water and mineral water.

  13. Comparison of Clinical Results and Injury Risk of Posterior Tibial Cortex Between Attune and Press Fit Condylar Sigma Knee Systems.

    PubMed

    Song, Sang Jun; Park, Cheol Hee; Liang, Hu; Kang, Se Gu; Park, Jong Jun; Bae, Dae Kyung

    2018-02-01

    We compared clinical and radiographic results after total knee arthroplasty (TKA) using Attune and Press Fit Condylar Sigma, and investigated whether use of the current prosthesis increased injury risk to the tibial cortex in Asian patients. We also assessed whether a preoperative posterior tibial slope angle (PSA) is associated with the injury when using the current prosthesis. The 300 TKAs with Attune (group A) were compared to the 300 TKAs with Press Fit Condylar Sigma (group B). Demographics were not different, except follow-up periods (24.8 vs 33.3 months, P < .001). The Western Ontario and McMaster Universities Index and range of motion were compared. A minimum distance between tibial component stem and posterior tibial cortex (mDSC) was compared. The correlation between preoperative PSA and mDSC was analyzed in group A. The postoperative Western Ontario and McMaster Universities Index and range of motion of group A were better than those of group B (17.7 vs 18.8, P = .004; 131.4° vs 129.0°, P = .008). The mDSC was shorter in group A (6.3 vs 7.0 mm, P < .001), which made up a higher proportion of the high-risk group for posterior tibial cortical injury with an mDSC of <4 mm (20.0% vs 10.7%, P = .002). A negative correlation was found between the preoperative PSA and mDSC in group A (r = -0.205, P < .001). The TKA using the current prosthesis provided more satisfactory results than the TKA using the previous prosthesis. However, the injury risk to the posterior tibial cortex increased in the knees with a large PSA when using the current prosthesis for Asian patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. A phase III randomized three-arm trial of physical therapist delivered pain coping skills training for patients with total knee arthroplasty: the KASTPain protocol

    PubMed Central

    2012-01-01

    Background Approximately 20% of patients report persistent and disabling pain following total knee arthroplasty (TKA) despite an apparently normally functioning prosthesis. One potential risk factor for unexplained persistent pain is high levels of pain catastrophizing. We designed a three-arm trial to determine if a pain coping skills training program, delivered prior to TKA, effectively reduces function-limiting pain following the procedure in patients with high levels of pain catastrophizing. Methods/design The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Discussion The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Trial Registration NCT01620983 PMID:22906061

  15. FuncPatch: a web server for the fast Bayesian inference of conserved functional patches in protein 3D structures.

    PubMed

    Huang, Yi-Fei; Golding, G Brian

    2015-02-15

    A number of statistical phylogenetic methods have been developed to infer conserved functional sites or regions in proteins. Many methods, e.g. Rate4Site, apply the standard phylogenetic models to infer site-specific substitution rates and totally ignore the spatial correlation of substitution rates in protein tertiary structures, which may reduce their power to identify conserved functional patches in protein tertiary structures when the sequences used in the analysis are highly similar. The 3D sliding window method has been proposed to infer conserved functional patches in protein tertiary structures, but the window size, which reflects the strength of the spatial correlation, must be predefined and is not inferred from data. We recently developed GP4Rate to solve these problems under the Bayesian framework. Unfortunately, GP4Rate is computationally slow. Here, we present an intuitive web server, FuncPatch, to perform a fast approximate Bayesian inference of conserved functional patches in protein tertiary structures. Both simulations and four case studies based on empirical data suggest that FuncPatch is a good approximation to GP4Rate. However, FuncPatch is orders of magnitudes faster than GP4Rate. In addition, simulations suggest that FuncPatch is potentially a useful tool complementary to Rate4Site, but the 3D sliding window method is less powerful than FuncPatch and Rate4Site. The functional patches predicted by FuncPatch in the four case studies are supported by experimental evidence, which corroborates the usefulness of FuncPatch. The software FuncPatch is freely available at the web site, http://info.mcmaster.ca/yifei/FuncPatch golding@mcmaster.ca Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Satisfactory Short-Term Results of Navigation-Assisted Gap-Balancing Total Knee Arthroplasty Using Ultracongruent Insert.

    PubMed

    Yoon, Jung-Ro; Yang, Jae-Hyuk

    2018-03-01

    The use of highly conforming ultracongruent (UC) polyethylene insert is bone-preserving and became a relatively common alternative to the conventional posterior stabilized total knee arthroplasty (TKA) design. The purpose of this study was to analyze the short-term clinical and radiologic results of UC insert TKA using the navigation-assisted gap-balancing technique. Two hundred thirty-three knees were operated with a mean follow-up period of 8.1 years (minimum of 5 years). Radiologic and clinical outcomes were assessed before operation and at latest follow-up using the Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index score. For statistical analysis, paired sample t-test and analysis of variance were used. Significance was considered as P < .05. According to the preoperative deformities (valgus, mild varus, and moderate varus), there were 23 cases (9.9%) of valgus deformity, 180 cases (77.3%) of mild varus deformity, and 30 cases (12.9%) of moderate varus deformity. Overall, the results at mean 8.1 years revealed an improvement in mean Knee Society Score (54 ± 12 to 92 ± 3) and mean Western Ontario and McMaster Universities Osteoarthritis Index scores (62 ± 14 to 17 ± 3). Overall, 220 of 233 cases (94.4%) were in neutral alignment (between -3° and +3°) at latest follow-up. There were no migrating or shifting prosthesis that should be considered as possible failure. There was 0% component revision rate. Navigation-assisted gap-balancing technique using UC insert TKA had satisfactory short-term outcome. Strict gap-balancing technique using the offset-type-force-controlled-spreader-system aided in the satisfactory results. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Implant Removal After Internal Fixation of a Femoral Neck Fracture: Effects on Physical Functioning.

    PubMed

    Zielinski, Stephanie M; Heetveld, Martin J; Bhandari, Mohit; Patka, Peter; Van Lieshout, Esther M M

    2015-09-01

    The effect of implant removal after internal fixation of a femoral neck fracture on physical functioning was analyzed. Characteristics of patients who had their implant removed were studied, as it is currently unknown from which type of patients implants are removed and what effect removal has on function. Secondary cohort study alongside a randomized controlled trial. Multicenter study in 14 hospitals. Patients who had their implant removed after internal fixation of a femoral neck fracture are compared with patients who did not. Patient characteristics and quality of life (Short Form 12, Western Ontario McMaster Osteoarthritis Index) were compared. Matched pairs were selected based on patient/fracture characteristics and prefracture physical functioning. Of 162 patients, 37 (23%) had their implant removed. These patients were younger (median age: 67 vs. 72 years, P = 0.024) and more often independently ambulatory prefracture (100% vs. 84%, P = 0.008) than patients who did not. They more often had evident implant back-out on x-rays (54% vs. 34%, P = 0.035), possibly related to a higher rate of Pauwels 3 fractures (41% vs. 22%, P = 0.032). In time, quality of life improved more in implant removal patients [+2 vs. -4 points, Short Form 12 (physical component), P = 0.024; +9 vs. 0 points, Western Ontario McMaster Osteoarthritis Index, P = 0.019]. Implant removal after internal fixation of a femoral neck fracture positively influenced quality of life. Implant removal patients were younger and more often independently ambulatory prefracture, more often had a Pauwels 3 fracture, and an evident implant back-out. Implant removal should be considered liberally for these patients if pain persists or functional recovery is unsatisfactory. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

  18. [The forgotten capitulation of evidence-based medicine].

    PubMed

    Schoemaker, Casper G; Smulders, Yvo M

    2015-01-01

    In 1992, the Canadian physician Gordon Guyatt wrote an article that is generally regarded as the starting point of evidence-based medicine (EBM). He described the ideas behind the McMaster residency programme for 'evidence-based practitioners', founded by David Sackett. Eight years later, in 2000, Guyatt concluded that this programme was too ambitious. In a new publication he described most doctors as 'evidence-users'. This editorial marks the transition from an individual to a collective form of EBM, emphasizing the use of evidence-based guidelines. The starting point of this collective form of EBM is not the well-known 1992 paper, but the forgotten editorial in 2000, which was described by Guyatt's colleagues as the capitulation of EBM.

  19. Synoptic evaluation of scale-dependent metrics for hydrographic line feature geometry

    USGS Publications Warehouse

    Stanislawski, Larry V.; Buttenfield, Barbara P.; Raposo, Paulo; Cameron, Madeline; Falgout, Jeff T.

    2015-01-01

    Methods of acquisition and feature simplification for vector feature data impact cartographic representations and scientific investigations of these data, and are therefore important considerations for geographic information science (Haunert and Sester 2008). After initial collection, linear features may be simplified to reduce excessive detail or to furnish a reduced-scale version of the features through cartographic generalization (Regnauld and McMaster 2008, Stanislawski et al. 2014). A variety of algorithms exist to simplify linear cartographic features, and all of the methods affect the positional accuracy of the features (Shahriari and Tao 2002, Regnauld and McMaster 2008, Stanislawski et al. 2012). In general, simplification operations are controlled by one or more tolerance parameters that limit the amount of positional change the operation can make to features. Using a single tolerance value can have varying levels of positional change on features; depending on local shape, texture, or geometric characteristics of the original features (McMaster and Shea 1992, Shahriari and Tao 2002, Buttenfield et al. 2010). Consequently, numerous researchers have advocated calibration of simplification parameters to control quantifiable properties of resulting changes to the features (Li and Openshaw 1990, Raposo 2013, Tobler 1988, Veregin 2000, and Buttenfield, 1986, 1989).This research identifies relations between local topographic conditions and geometric characteristics of linear features that are available in the National Hydrography Dataset (NHD). The NHD is a comprehensive vector dataset of surface 18 th ICA Workshop on Generalisation and Multiple Representation, Rio de Janiero, Brazil 2015 2 water features within the United States that is maintained by the U.S. Geological Survey (USGS). In this paper, geometric characteristics of cartographic representations for natural stream and river features are summarized for subbasin watersheds within entire regions of the

  20. Podcasts: Are They an Effective Tool to Enhance Student Learning? A Case Study from McMaster University, Hamilton Canada

    ERIC Educational Resources Information Center

    Vajoczki, Susan; Watt, Susan; Marquis, Nick; Holshausen, Katherine

    2010-01-01

    As universities turn to technology to become more learner-centred and address challenges created by increasing class sizes, changing consumer expectations, and increasing numbers of disability accommodation requests it is important to test the utility of technology solutions. This presentation describes a study to determine the effects of…

  1. Patient expectations predict greater pain relief with joint arthroplasty.

    PubMed

    Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar

    2009-08-01

    We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P < .05). Patient expectation of pain relief after joint arthroplasty is an important predictor of outcomes at 1 year.

  2. A Brief Review of Handgrip Strength and Sport Performance.

    PubMed

    Cronin, John; Lawton, Trent; Harris, Nigel; Kilding, Andrew; McMaster, Daniel T

    2017-11-01

    Cronin, J, Lawton, T, Harris, N, Kilding, A, and McMaster, DT. A brief review of handgrip strength and sport performance. J Strength Cond Res 31(11): 3187-3217, 2017-Tests of handgrip strength (HGS) and handgrip force (HGF) are commonly used across a number of sporting populations. Measures of HGS and HGF have also been used by practitioners and researchers to evaluate links with sports performance. This article first evaluates the validity and reliability of various handgrip dynamometers (HGD) and HGF sensors, providing recommendations for procedures to ensure that precise and reliable data are collected as part of an athlete's testing battery. Second, the differences in HGS between elite and subelite athletes and the relationships between HGS, HGF, and sports performance are discussed.

  3. Association Between Knee Osteoarthritis and Functional Changes in Ankle Joint and Achilles Tendon.

    PubMed

    Elbaz, Avi; Magram-Flohr, Irina; Segal, Ganit; Mor, Amit; Debi, Ronen; Kalichman, Leonid

    Increasing evidence has shown that biomechanical forces often drive the progression of knee osteoarthritis (OA). Attention should be given to the changes in adjacent joints and their relation to knee OA. The purpose of the present study was to examine the changes in Achilles tendon thickness of individuals with knee OA and to evaluate the correlation between Achilles tendon thickness and knee OA severity in a case-control prospective observational study. A total of 93 participants with no previous ankle injuries were recruited. Of the 93 participants, 63 had knee OA of the medial compartment and 30 served as controls. The subjects underwent a clinical examination that included measurements of weight, height, Achilles tendon thickness, and 1-leg heel rise. The subjects also underwent a computerized gait test and completed the Hebrew version of the Western Ontario and McMaster Osteoarthritis Index and 36-item short-form (SF-36) health survey. Significant difference was found in Achilles tendon thickness between the subjects with knee OA and the healthy controls (17.1 ± 3.4 versus 15.1 ± 3.1; p = .009). Significant differences were also found between the 2 groups in the 1-leg heel rise test, Western Ontario and McMaster Osteoarthritis Index scores, SF-36 scores, and all gait measures. Significant correlations were found between the Achilles tendon thickness and the following measures: weight (r = 0.46), body mass index (r = 0.55), Kellgren and Lawrence OA severity grade (r = 0.25), 1-leg heel rises (r = -0.50), and SF-36 score (r = -0.25). Subjects with knee OA presented with a thicker Achilles tendon compared with the healthy controls. Furthermore, a significant correlation between Achilles tendon thickness and knee OA severity was found. A comprehensive assessment of the Achilles tendon and ankle joint should be a part of the knee OA evaluation process. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All

  4. The effect of general surgery clerkship rotation on the attitude of medical students towards general surgery as a future career.

    PubMed

    Al-Heeti, Khalaf N M; Nassar, Aussama K; Decorby, Kara; Winch, Joanne; Reid, Susan

    2012-01-01

    Literature suggests declining interest in General Surgery (GS) and other surgical specialties, with fewer Canadian medical residency applicants identifying a surgical specialty as their first choice. Although perceptions of surgical careers may begin before enrollment in clerkship, clerkship itself provides the most concentrated environment for perceptions to evolve. Most students develop perceptions about specialties during their clinical clerkships. This study examines the immediate impact of GS clerkship on student attitudes toward GS as a career, and on preferences towards GS compared with other specialties. A pre-post design involved 61 McMaster clinical clerks. Two instruments were used to collect data from students over the course of clerkship (2008-2009). Paired comparison (PC) compared ranking of career choices before and after clerkship. Semantic differential (SD) measured attitudes toward GS and variables that may have affected attitudes before and after clerkship. Analyses used SPSS 16.0 (SPSS Inc., Chicago, IL). Clerks ranked preferences for GS changed substantially after clerkship, moving from the 10th to the 5th position compared with other specialties. Ranks of surgical subspecialties also changed, though GS demonstrated the largest improvement. SD results were consistent with PC, showing improved attitudes after rotation, with differences both statistically and practically significant (t = 3.81, p < 0.000, effect size = 0.23). Results indicated that attitudes toward all areas related to GS clerkship (attending physicians, surgical residents, ward nurses, scrub nurses, workload, knowledge achieved, technical skills acquired) improved significantly except attitude toward technical skills acquired. Clinical clerkship at McMaster was a positive experience and significantly enhanced preferences towards GS and attitudes towards GS as a career. Medical schools should foster positive interaction between clinical clerks and staff (including attending

  5. Multiple mini-interviews: same concept, different approaches.

    PubMed

    Knorr, Mirjana; Hissbach, Johanna

    2014-12-01

    Increasing numbers of educational institutions in the medical field choose to replace their conventional admissions interviews with a multiple mini-interview (MMI) format because the latter has superior reliability values and reduces interviewer bias. As the MMI format can be adapted to the conditions of each institution, the question of under which circumstances an MMI is most expedient remains unresolved. This article systematically reviews the existing MMI literature to identify the aspects of MMI design that have impact on the reliability, validity and cost-efficiency of the format. Three electronic databases (OVID, PubMed, Web of Science) were searched for any publications in which MMIs and related approaches were discussed. Sixty-six publications were included in the analysis. Forty studies reported reliability values. Generally, raising the number of stations has more impact on reliability than raising the number of raters per station. Other factors with positive influence include the exclusion of stations that are too easy, and the use of normative anchored rating scales or skills-based rater training. Data on criterion-related validities and analyses of dimensionality were found in 31 studies. Irrespective of design differences, the relationship between MMI results and academic measures is small to zero. The McMaster University MMI predicts in-programme and licensing examination performance. Construct validity analyses are mostly exploratory and their results are inconclusive. Seven publications gave information on required resources or provided suggestions on how to save costs. The most relevant cost factors that are additional to those of conventional interviews are the costs of station development and actor payments. The MMI literature provides useful recommendations for reliable and cost-efficient MMI designs, but some important aspects have not yet been fully explored. More theory-driven research is needed concerning dimensionality and construct

  6. IMpact of Platelet Rich plasma OVer alternative therapies in patients with lateral Epicondylitis (IMPROVE): protocol for a multicenter randomized controlled study: a multicenter, randomized trial comparing autologous platelet-rich plasma, autologous whole blood, dry needle tendon fenestration, and physical therapy exercises alone on pain and quality of life in patients with lateral epicondylitis.

    PubMed

    Chiavaras, Mary M; Jacobson, Jon A; Carlos, Ruth; Maida, Eugene; Bentley, Todd; Simunovic, Nicole; Swinton, Marilyn; Bhandari, Mohit

    2014-09-01

    Lateral epicondylitis, commonly known as tennis elbow, is the most common cause of lateral elbow pain and the second most frequently diagnosed musculoskeletal disorder in the neck and upper limb in a primary care setting. Many therapeutic options, including conservative, surgical, and minimally invasive procedures, have been advocated for the treatment of lateral epicondylitis. Although numerous small studies have been performed to assess the efficacy of various treatments, there are conflicting results with no clear consensus on the optimal treatment. In an economic environment with limited health care resources, it is paramount that optimal cost-effective therapies with favorable patient-important outcomes be identified. This is a protocol paper which outlines a multicenter, multidisciplinary, single-blinded, four-arm randomized controlled trial, comparing platelet-rich plasma (PRP), whole blood injection, dry needle tendon fenestration, and sham injection with physical therapy alone for the treatment of lateral epicondylitis. Patients are screened based on pre-established eligibility criteria and randomized to one of the four study groups using an Internet-based system. The patients are followed at 6-week, 12-week, 24-week, and 52-week time points to assess the primary and secondary outcomes of the study. The primary outcome is pain. Secondary outcomes include health-related quality of life and ultrasound appearance of the common extensor tendon. Two university centers (McMaster University and the University of Michigan) are currently recruiting patients. We have planned a sample size of 100 patients (25 patients per arm) to ensure over 80% power to detect a three-point difference in pain scores at 52 weeks of follow-up. This study has ethics approval from the McMaster University Research Ethics Board (REB# 12-146) and the University of Michigan Institutional Review Board (IRB# HUM00067750). Successful completion of this proposed study will significantly impact

  7. Clinical Practice Guidelines on the Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention in Saudi Arabia.

    PubMed

    Al-Mandeel, Hazem Mahmoud; Sagr, Emad; Sait, Khalid; Latifah, Hassan Mohamed; Al-Obaid, Abdulaziz; Al-Badawi, Ismail A; Alkushi, Abdulmohsen O; Salem, Hany; Massoudi, Nada S; Schunemann, Holger; Mustafa, Reem A; Brignardello-Petersen, Romina

    2016-01-01

    Cervical cancer is the third most common gynecological malignancy in Saudi women with an estimated incidence rate of 1.9 cases per 100 000 women-years. More than 40% of cervical cancer cases are diagnosed at advanced stages due to lack of a routine screening program in Saudi Arabia. Thus, national guidelines for routine screening and treatment of precancerous cervical lesions are needed. The Saudi Centre for Evidence-Based Healthcare invited a panel of local experts and partnered them with a team from McMaster University in Canada for methodological support, to develop national clinical practice guidelines on the screening and treatment of precancerous lesions for cervical cancer. After the panel identified key clinical questions, the McMaster University working group updated existing systematic reviews that had been used for the 2013 WHO Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Recommendations were based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. Those recommendations took into account the available evidence, patient values and preferences, and resource use in the Saudi context. The panel provided recommendations on two major issues: screening for precancerous lesions (cervical intraepithelial neoplasia 2 & 3) and treatment of those lesions to prevent cervical cancer in women who tested positive after screening. The Saudi expert panel recommends using the HPV DNA test followed by colposcopy or cytology (Pap test) followed by colposcopy to screen for CIN2+ in women at risk of cervical cancer. The panel recommends cryotherapy or loop excision electrosurgery procedure (LEEP) over cold knife cone biopsy to treat women at risk of cervical cancer that tests positive for CIN2+. Universal screening for precancerous cervical dysplasia in women in Saudi Arabia is recommended using HPV testing and or cytology. Either cryotherapy or LEEP are preferred for treatment. National

  8. A comparison between patient recall and concurrent measurement of preoperative quality of life outcome in total hip arthroplasty.

    PubMed

    Howell, Jonathan; Xu, Min; Duncan, Clive P; Masri, Bassam A; Garbuz, Donald S

    2008-09-01

    The objective is to evaluate the reliability of patients' recall of preoperative pain and function during the immediate postoperation period after total hip arthroplasty. A prospective cohort of 104 patients completed a survey about their quality of life before operation, and recalled preoperative status at 3 days, 6 weeks, and 12 weeks after operation. Quality of life was measured by the Western Ontario and McMaster University Osteoarthritis Index, the Oxford-12 hip score, and the 12-item Short-Form score. The intraclass correlation coefficient and Spearman correlation coefficient were used to compare preoperative quality of life scores to the scores recalled. The reliability of recall remained high up to 3 months postoperation. Patients are able to accurately recall their preoperative function for up to 3 months after total hip arthroplasty.

  9. Collaborative fieldwork education with student occupational therapists and student occupational therapist assistants.

    PubMed

    Jung, Bonny; Sainsbury, Sandy; Grum, Rosa Maria; Wilkins, Seanne; Tryssenaar, Joyce

    2002-04-01

    The profession of occupational therapy has a long history of working collaboratively with support personnel. This paper describes the process of a fieldwork education partnership developed between the McMaster University, BHSc (OT) Program and the Mohawk College, Occupational Therapist Assistant and Physical Therapist Assistant Program. Eight student occupational therapists and eight student occupational therapist assistants learned together in a variety of fieldwork settings, either in pairs or in groups. Both groups of students kept weekly journals of the experience and completed a post placement questionnaire. The journals were inductively analysed using a retrospective content analysis. The four emergent themes identified from the data are learning about each other's role, collaborative learning, impact on client care and future practice, and resistance to roles. Recommendations for future collaborations are discussed.

  10. Increasing transcultural awareness: the McMaster-Aga Khan-CIDA Project workshop model.

    PubMed

    Smith, S E

    1997-01-01

    McMaster-Aga Khan-CIDA Project personnel at McMaster University School of Nursing over a period of four years designed and conducted eight one-day introductory workshops for nurses, faculty, staff, host families, and others involved with Pakistani nurses and Lady Health Visitors studying in Canada. The workshops (entitled Increasing Intercultural Awareness) assisted the Canadian and international participants to improve their awareness and knowledge of transcultural communication in preparation for working and socializing together. Using a participatory and active-learning approach, the workshop method introduced participants to transcultural communication; emphasized appreciation of cultural values, similarities and differences; and provided country-specific information on Pakistan. This article outlines the workshop design and rationale and describes specific examples of the transcultural nursing principles, practices, and teaching activities included in the one-day event.

  11. Is Electrocautery of Patella Useful in Patella Non-Resurfacing Total Knee Arthroplasty?: A Prospective Randomized Controlled Study.

    PubMed

    Kwon, Sae Kwang; Nguku, Levis; Han, Chang Dong; Koh, Yong-Gon; Kim, Dong-Wook; Park, Kwan Kyu

    2015-12-01

    There is controversy over the need for electrocauterization of the patella in non-resurfacing total knee arthroplasty (TKA). We investigated whether this procedure is beneficial through a prospective randomized controlled trial. Fifty patients who underwent electrocautery were compared with 50 patients who did not undergo this procedure. We determined cartilage status, preoperative and postoperative American Knee Society (AKS) score, the Western Ontario and McMaster Universities score (WOMAC) and the Patellofemoral (PF) scores for a minimum of 5 years. The two groups did not differ significantly in demographics, intraoperative cartilage status, or preoperative or postoperative outcomes. No complications were detected in either group. We found no benefits of electrocautery of the patella in patellar non-resurfacing TKA up to 5 years. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Patellofemoral arthroplasty in a bilateral Syme's amputee.

    PubMed

    Kanna, Raj; Barrett, David S

    2016-01-01

    We present the case of a 50-year-old woman, who is a bilateral Syme's amputee and subsequently underwent patellofemoral arthroplasty (PFA) for osteoarthritis primarily involving the patellofemoral (PF) joint. History and physical examination were suggestive of severe PF arthritis without patellar instability of the right knee. The diagnosis was confirmed by roentgenogram and a PFA was performed. A slightly modified rehabilitation program was implemented and the patient was followed until 6 years after surgery. In comparison to the preoperative scores, the Oxford, the Western Ontario and McMaster Universities (WOMAC), the Knee Society, and the Hospital for Special Surgery Knee Scores improved significantly (p < 0.05) at the time of final follow-up. PF problems specific to below-knee amputees, factors to be considered before performing PFA, and the drawbacks of other treatment modalities in these patients have been discussed.

  13. A comparison study of psychological, family function marital and life satisfactions of polygamous and monogamous women in Jordan.

    PubMed

    Al-Krenawi, Alean; Graham, John R; Al Gharaibeh, Fakir

    2011-10-01

    This study surveyed a 2009 convenience sampling of 199 women, 93 of whom were first (or senior) wives in polygamous marriages and 106 were wives in monogamous marriages. We deployed the McMaster Family Assessment Device (FAD), ENRICH marital satisfaction questionnaire, SCL-90 mental health symptoms checklist, Rosenberg self-esteem (SE) scale, and Diener, Emmons, Larsen, and Griffin life satisfaction scale, a basic sociodemographic scale, including attitudes towards polygamy. Women from polygamous families experienced more problems in family functioning, marital relations, and reported low self-esteem, less satisfaction with life, and more somatization, interpersonal sensitivity, depression, anxiety, hostility, paranoid ideation, psychoticism and their general severity index was higher (GSI). More women in polygamous marriages agreed with the practice of polygamy, as compared to their monogamous counterparts. The conclusion considers implications for mental health practice, policy, and further research.

  14. Poor WOMAC scores in contralateral knee negatively impact TKA outcomes: data from the osteoarthritis initiative.

    PubMed

    Kahn, Timothy L; Soheili, Aydin C; Schwarzkopf, Ran

    2014-08-01

    While total knee arthroplasty (TKA) has been shown to have excellent outcomes, a significant proportion of patients experience relatively poor post-operative function. In this study, we test the hypothesis that the level of osteoarthritic symptoms in the contralateral knee at the time of TKA is associated with poorer post-operative outcomes in the operated knee. Using longitudinal cohort data from the Osteoarthritis Initiative (OAI), we included 171 patients who received a unilateral TKA. We compared pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in the contralateral knee to post-operative WOMAC scores in the index knee. Pre-operative contralateral knee WOMAC scores were associated with post-operative index knee WOMAC Total scores, indicating that the health of the pre-operative contralateral knee is a significant factor in TKA outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. The influence of optimism on functionality after total hip replacement surgery.

    PubMed

    Balck, Friedrich; Lippmann, Maike; Jeszenszky, Csilla; Günther, Klaus-Peter; Kirschner, Stephan

    2016-08-01

    Among other factors, optimism has been shown to significantly influence the course of some diseases (cancer, HIV, coronary heart disease). This study investigated whether optimism of a patient before a total hip replacement can predict the functionality of the lower limbs 3 and 6 months after surgery. A total of 325 patients took part in the study (age: 58.7 years; w: 55%). The functionality was measured with the Western Ontario and McMaster Universities arthrosis index, and optimism with the Life Orientation Test. To analyse the influences of age, gender and optimism, general linear models were calculated. In optimistic patients, functionality improved significantly over time. The study showed a clear influence of dispositional optimism on the recovery after total hip replacement in the first 3 months after surgery. © The Author(s) 2015.

  16. Efficacy and safety of plasma rich in growth factors intra-articular infiltrations in the treatment of knee osteoarthritis.

    PubMed

    Anitua, Eduardo; Sánchez, Mikel; Aguirre, José Javier; Prado, Roberto; Padilla, Sabino; Orive, Gorka

    2014-08-01

    The goal of this study was to systematically review the efficacy and safety of plasma rich in growth factors (PRGF) as a treatment for reducing symptoms in patients with knee osteoarthritis. A comprehensive and systematic literature search was conducted for PRGF treatment of knee osteoarthritis following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. All the studies had to include a PRGF group and a control group. Pre- and post-treatment measures of joint pain, reduced function, and stiffness were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Score, International Knee Documentation Committee score, Lequesne index, or number of Outcome Measures for Rheumatology Committee and Osteoarthritis Research Society International Standing Committee for Clinical Trials Response Criteria Initiative (OMERACT-OARSI) responders, with a follow-up period of at least 4 weeks. An assessment of both the quality and risk of bias of the studies was conducted. The literature search yielded 91 citations, but only 5 were eligible publications that met the inclusion criteria (2 randomized controlled trials, 2 prospective studies, and 1 retrospective analysis). Two studies were rated as having a low risk of bias whereas 3 had a high risk. In both randomized controlled trials, it was observed that after 6 months of treatment, the number of patients with a pain reduction of more than 50% was significantly higher in the PRGF group. In 2 other studies, the patients treated with PRGF showed a significant pain reduction compared with the control group. The remaining variables (Western Ontario and McMaster Universities Osteoarthritis Index scale for pain, function, and stiffness; Lequesne index; Knee Injury and Osteoarthritis Outcome Score scale; and number of OMERACT-OARSI responders) showed a statistically significant superiority of the group treated with PRGF. The current

  17. Increasing the quantity and quality of searching for current best evidence to answer clinical questions: protocol and intervention design of the MacPLUS FS Factorial Randomized Controlled Trials.

    PubMed

    Agoritsas, Thomas; Iserman, Emma; Hobson, Nicholas; Cohen, Natasha; Cohen, Adam; Roshanov, Pavel S; Perez, Miguel; Cotoi, Chris; Parrish, Rick; Pullenayegum, Eleanor; Wilczynski, Nancy L; Iorio, Alfonso; Haynes, R Brian

    2014-09-20

    Finding current best evidence for clinical decisions remains challenging. With 3,000 new studies published every day, no single evidence-based resource provides all answers or is sufficiently updated. McMaster Premium LiteratUre Service--Federated Search (MacPLUS FS) addresses this issue by looking in multiple high quality resources simultaneously and displaying results in a one-page pyramid with the most clinically useful at the top. Yet, additional logistical and educational barriers need to be addressed to enhance point-of-care evidence retrieval. This trial seeks to test three innovative interventions, among clinicians registered to MacPLUS FS, to increase the quantity and quality of searching for current best evidence to answer clinical questions. In a user-centered approach, we designed three interventions embedded in MacPLUS FS: (A) a web-based Clinical Question Recorder; (B) an Evidence Retrieval Coach composed of eight short educational videos; (C) an Audit, Feedback and Gamification approach to evidence retrieval, based on the allocation of 'badges' and 'reputation scores.' We will conduct a randomized factorial controlled trial among all the 904 eligible medical doctors currently registered to MacPLUS FS at the hospitals affiliated with McMaster University, Canada. Postgraduate trainees (n=429) and clinical faculty/staff (n=475) will be randomized to each of the three following interventions in a factorial design (AxBxC). Utilization will be continuously recorded through clinicians’ accounts that track logins and usage, down to the level of individual keystrokes. The primary outcome is the rate of searches per month per user during the six months of follow-up. Secondary outcomes, measured through the validated Impact Assessment Method questionnaire, include: utility of answers found (meeting clinicians’ information needs), use (application in practice), and perceived usefulness on patient outcomes. Built on effective models for the point

  18. In-patient rehabilitation in haemophilic subjects with total knee arthroplasty.

    PubMed

    Viliani, T; Zambelan, G; Pandolfi, C; Martini, C; Morfini, M; Pasquetti, P; Innocenti, M

    2011-09-01

    Total knee arthroplasty (TKA) is a major orthopaedic surgery intervention, indicated for severe haemophilic arthropathy. The aim of our study was to analyse rehabilitation outcome in haemophilic patients after TKA. A consecutive series of 21 patients (23 knees) was retrospectively evaluated. The mean age was 37 ± 8 years (range 22-55). Physiotherapy treatment was performed twice a day for 5 days week⁻¹, for 3 h day⁻¹. Assessment included knee range of motion (ROM), Visual Analogue Scale (VAS) for pain evaluation, Western Ontario and McMaster University (WOMAC) Score for functional outcome, Medical Research Council Scale (MRC) for quadriceps muscle strength evaluation, incidence of adverse events and a self-reported questionnaire. The patients'data were recorded before surgery (t0), at Rehabilitation Unit admission (t1), before discharge (t2) and at follow-up (t3), 11-48 months after rehabilitation. Western Ontario and McMaster University Score (ref. score: 0-96) was 56.7 ± 12 at t0 and 6.2 ± 6 at t3 (t3 vs. t0: P < 0.001). Visual Analogue Scale (ref. score: 0-10) decreased from 5.0 ± 2 at t1 to 2.1 ± 2 at t2 (t2 vs. t1: P < 0.05) and to 0.1 ± 0 at t3 (t3 vs. t2: P < 0.05). Flexion degrees increased from 43.4 ± 21° at t1 to 80.2 ± 15° at t2 (t2 vs. t1: P < 0.001) and to 95.0 ± 15° at t3 (t3 vs t2: P < 0.05). According to MRC (ref. score: 0-5), quadriceps muscle strength increased from 2.3 ± 0.6 at t1 to 3.6 ± 0.5 at t2 (t2 vs. t1: P < 0.05). Adverse events were found in four patients. Patients' satisfaction on their outcome at follow-up was referred as good by 72% of patients or excellent by 28% of patients. Postsurgical intensive rehabilitation in haemophilic patients resulted effective, safe and feasible. © 2011 Blackwell Publishing Ltd.

  19. Bipolar Versus Unipolar Intraarticular Pulsed Radiofrequency Thermocoagulation in Chronic Knee Pain Treatment: A Prospective Randomized Trial.

    PubMed

    Gulec, Ersel; Ozbek, Hayri; Pektas, Sinan; Isik, Geylan

    2017-03-01

    Chronic knee pain is a major widespread problem causing significant impairment of daily function. Pulsed radiofrequency has been shown to reduce severe chronic joint pain as a non-pharmacological and less invasive treatment method. We aimed to compare the effectiveness of unipolar and bipolar intraarticular pulsed radiofrequency methods in chronic knee pain control. Prospective, randomized, double-blind study. Pain clinic in Cukurova University Faculty of Medicine. One hundred patients, aged 20 - 70 years with grade 2 or 3 knee osteoarthritis were included in this study. Patients were randomly allocated into 2 groups to receive either unipolar (group U, n = 50) or bipolar (group B, n = 50) intraarticular pulsed radiofrequency (IAPRF) with a 45 V voltage, 2 Hz frequency, 42° C temperature, 10 msec pulse width, and 10 minute duration. We recorded visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index LK 3.1WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index LK 3.1) scores of patients at baseline and one, 4, and 12 weeks after the procedure. The primary outcome was the percentage of patients with ≥ 50% reduction in knee pain at 12 weeks after the procedure. There was a significant difference between the groups according to VAS scores at all post-intervention time points. In group B, 84% of patients, and in the group U, 50% of patients achieved at least 50% knee pain relief from the baseline to 3 months. In group B, WOMAC scores were significantly lower than the group U at one and 3 months. Lack of long-term clinical results and supportive laboratory tests. Bipolar IAPRF is more advantageous in reducing chronic knee pain and functional recovery compared with unipolar IAPRF. Further studies with longer follow-up times, laboratory-based tests, and different generator settings are required to establish the clinical importance and well-defined mechanism of action of PRF. This study protocol was registered at

  20. Sidescan-Sonar Imagery and Surficial Geologic Interpretations of the Sea Floor in Central Rhode Island Sound

    USGS Publications Warehouse

    McMullen, K.Y.; Poppe, L.J.; Denny, J.F.; Haupt, T.A.; Crocker, J.M.

    2008-01-01

    The U.S. Geological Survey (USGS) has been working with the National Oceanic and Atmospheric Administration (NOAA) to interpret the surficial geology of areas along the northeastern coast of the United States. During 2004, the NOAA Ship RUDE conducted Hydrographic Survey H11321 in Rhode Island Sound. This sidescan-sonar and bathymetry survey covers an area of 93 km? located 12 km southeast of Brenton Point, RI in water depths of 28-39 m (fig. 1). The purpose of this report is to delineate sea floor features and sedimentary environments of this area in central Rhode Island Sound using sidescan-sonar and bathymetric data from NOAA Survey H11321 and seismic-reflection data from a previous USGS field study (Needell and others, 1983a). This is important for the study of benthic habitats and provides a framework for future research. Prior work in this area includes the mapping of surface sediments and surficial geology. McMaster (1960) collected sediment samples from Rhode Island Sound and Narragansett Bay and mapped our study area as having a sandy sea floor. In addition, one sample of sand from the National Ocean Service (NOS) Hydrographic Database came from a location in the northeast part of our study area in 1939 (fig. 2; Poppe and others, 2003). McMaster and others (1968) used seismic-reflection profiles to map the locations of a cuesta of Cretaceous sediments crossing Rhode Island Sound and post-Cretaceous drainage channels. Knebel and others (1982) identified sedimentary environments in Rhode Island Sound using sidescan sonographs. Needell and others (1983b) studied the Quaternary geology and mapped the structure, sedimentary environments, and geologic hazards in Rhode Island Sound using sidescan-sonar and seismic-reflection data. Sidescan-sonar and bathymetric data from NOAA Survey H11320, which overlaps the far eastern edge of our study area, was interpreted to consist of basins surrounded by a moraine and bathymetric highs composed of till with areas of rocks

  1. Patellofemoral arthroplasty in a bilateral Syme's amputee

    PubMed Central

    Kanna, Raj; Barrett, David S.

    2016-01-01

    We present the case of a 50-year-old woman, who is a bilateral Syme's amputee and subsequently underwent patellofemoral arthroplasty (PFA) for osteoarthritis primarily involving the patellofemoral (PF) joint. History and physical examination were suggestive of severe PF arthritis without patellar instability of the right knee. The diagnosis was confirmed by roentgenogram and a PFA was performed. A slightly modified rehabilitation program was implemented and the patient was followed until 6 years after surgery. In comparison to the preoperative scores, the Oxford, the Western Ontario and McMaster Universities (WOMAC), the Knee Society, and the Hospital for Special Surgery Knee Scores improved significantly (p < 0.05) at the time of final follow-up. PF problems specific to below-knee amputees, factors to be considered before performing PFA, and the drawbacks of other treatment modalities in these patients have been discussed. PMID:26908975

  2. Report on "Methodologies for Investigating Microbial-Mineral Interactions: A Clay Minerals Society Short Course"

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Maurice, Patricia A.

    2010-02-08

    A workshop entitled, “Methods of Investigating Microbial-Mineral Interactions,” was held at the Clay Minerals Society meeting at the Pacific Northwest National Laboratory in Richland, WA on June 19, 2004. The workshop was organized by Patricia A. Maurice (University of Notre Dame) and Lesley A. Warren (McMaster University, CA). Speakers included: Dr. P. Bennett, Dr. J. Fredrickson (PNNL), Dr. S. Lower (Ohio State University), Dr. P. Maurice, Dr. S. Myneni (Princeton University), Dr. E. Shock (Arizona State), Dr. M. Tien (Penn State), Dr. L. Warren, and Dr. J. Zachara (PNNL). There were approximately 75 attendees at the workshop, including more thanmore » 20 students. A workshop volume was published by the Clay Minerals Society [Methods for Study of Microbe-Mineral Interactions (2006), CMS Workshop Lectures, vol 14(Patricia A. Maurice and Leslie A. Warren, eds.) ISBN 978-1-881208-15-0, 166 pp.]« less

  3. LabPatch, an acquisition and analysis program for patch-clamp electrophysiology.

    PubMed

    Robinson, T; Thomsen, L; Huizinga, J D

    2000-05-01

    An acquisition and analysis program, "LabPatch," has been developed for use in patch-clamp research. LabPatch controls any patch-clamp amplifier, acquires and records data, runs voltage protocols, plots and analyzes data, and connects to spreadsheet and database programs. Controls within LabPatch are grouped by function on one screen, much like an oscilloscope front panel. The software is mouse driven, so that the user need only point and click. Finally, the ability to copy data to other programs running in Windows 95/98, and the ability to keep track of experiments using a database, make LabPatch extremely versatile. The system requirements include Windows 95/98, at least a 100-MHz processor and 16 MB RAM, a data acquisition card, digital-to-analog converter, and a patch-clamp amplifier. LabPatch is available free of charge at http://www.fhs.mcmaster.ca/huizinga/.

  4. Ethnicity and patient's perception of risk in joint replacement surgery.

    PubMed

    Gandhi, Rajiv; Razak, Fahad; Davey, J Roderick; Mahomed, Nizar N

    2008-08-01

    Despite much evidence showing racial disparities in the use of surgical procedures, it is unknown whether ethnicity affects perception of surgical risk. We surveyed 1609 patients undergoing primary hip or knee replacement surgery. Relevant covariates including demographic data, body mass index (BMI), sex, comorbidities, education, and ethnicity were recorded. Pain and joint functional status were assessed at baseline and at 1-year followup with the Western Ontario McMaster University Osteoarthritis Index (WOMAC) pain and function scores. Risk perception was assessed with 3 survey questions. Non-European patients had greater functional disability and pain prior to surgery and demonstrated significantly greater perception of risk than European patients (p < 0.001). Independent of other covariates, non-European ethnicity was an independent predictor of a greater perception of risk (p < 0.05). Patient ethnicity is an important factor to consider in understanding a patient's perception of risk in joint replacement surgery.

  5. The effect of mud therapy on pain relief in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials.

    PubMed

    Liu, Hua; Zeng, Chao; Gao, Shu-guang; Yang, Tuo; Luo, Wei; Li, Yu-sheng; Xiong, Yi-lin; Sun, Jin-peng; Lei, Guang-hua

    2013-10-01

    A meta-analysis was conducted to examine the effect of mud therapy on pain relief in patients with knee osteoarthritis (OA). A detailed search of PubMed®/MEDLINE® was undertaken to identify randomized controlled trials and prospective comparative studies published before 9 March 2013 that compared mud therapy with control group treatments in patients with knee OA. A quantitative meta-analysis of seven studies (410 patients) was performed. There was a significant difference between the groups in the visual analogue scale pain score (standardized mean difference [SMD] -0.73) and Western Ontario and McMaster Universities Osteoarthritis Index pain score (SMD -0.30), with differences in favour of mud therapy. Mud therapy is a favourable option for pain relief in patients with knee OA. Additional high-quality randomized controlled trials need to be conducted to explore this issue further and to confirm this conclusion.

  6. Hydrotherapy after total knee arthroplasty. A follow-up study.

    PubMed

    Giaquinto, S; Ciotola, E; Dall'Armi, V; Margutti, F

    2010-01-01

    The study evaluated the subjective functional outcome following total knee arthroplasty (TKA) in participants who underwent hydrotherapy (HT) six months after discharge from a rehabilitation unit. A total of 70 subjects, 12 of which were lost at follow-up, were randomly assigned to either a conventional gym treatment (N=30) or HT (N=28). A prospective design was performed. Participants were interviewed with Western-Ontario McMasters Universities Osteoarthritis Index (WOMAC) at admission, at discharge and six months later. Kruskal-Wallis and Wilcoxon tests were applied for statistical analysis. Both groups improved. The WOMAC subscales, namely pain, stiffness and function, were all positively affected. Statistical analysis indicates that scores on all subscales were significantly lower for the HT group. The benefits gained by the time of discharge were still found after six months. HT is recommended after TKA in a geriatric population. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  7. Efficacy of orthotic immobilization of the unstable subaxial cervical spine of the elderly patient: investigation in a cadaver model

    PubMed Central

    Bednar, Drew A.

    2004-01-01

    Objective To assess the efficacy of soft, semirigid and hard cervical collars to immobilize the neck in a destabilized cadaver model. Design This is a laboratory experiment. Setting The anatomy research lab of McMaster University. Patients None. Fresh cadavers from elderly patients suffering terminal medical illness and free of cervical structural disease were studied. Interventions Destabilizing discoligamentous lesions of the neck were created in the cadavers. Radiographs were taken in maximum displacement in the prone, decubitus and side-bending positions, first unsupported and then with soft, semirigid and hard collars applied. Displacements in angulation and translation were measured from the radiographs. Outcome measures Radiographic displacement under gravity load. Results In all cases there was no effective limitation of pathological displacement, and in many cases displacement was increased after collar application. Conclusions Cervical collars do not effectively support the unstable neck, and may be ineffective in preventing pathological displacements. PMID:15362326

  8. Factors associated with the mental health of adolescents when a parent has cancer.

    PubMed

    Lindqvist, B; Schmitt, F; Santalahti, P; Romer, G; Piha, J

    2007-08-01

    This study explored factors associated with the mental health in adolescents (ages 11-17; n = 54) within 12 months after a parent had been diagnosed with cancer. A control group was included (ages 11-17; n = 49). A demographic questionnaire, the SF-8 Health Survey, the Youth Self Report and the McMaster Family Assessment Device were used. Similar levels of psychological distress and healthy family functioning were reported in the clinical and the control group. No effect of gender of the ill parent and that of the adolescent was found. A negative correlation was found between the physical health of the ill parent and the mental health of the adolescent. Healthy family functioning correlated with less psychological distress in adolescents with a parent with cancer. Open communication, flexible problem solving and appropriate affective involvement were significant predictors for less psychological distress in the adolescents. The study concludes that a healthy family functioning facilitated the adolescent's adjustment to parental cancer.

  9. Guidelines for Feeding Very Low Birth Weight Infants

    PubMed Central

    Dutta, Sourabh; Singh, Balpreet; Chessell, Lorraine; Wilson, Jennifer; Janes, Marianne; McDonald, Kimberley; Shahid, Shaneela; Gardner, Victoria A.; Hjartarson, Aune; Purcha, Margaret; Watson, Jennifer; de Boer, Chris; Gaal, Barbara; Fusch, Christoph

    2015-01-01

    Despite the fact that feeding a very low birth weight (VLBW) neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas. PMID:25580815

  10. Press-fit versus threaded acetabular cups in total hip arthroplasty: Functional and radiological results after five years.

    PubMed

    Ellenrieder, Martin; Bader, Rainer; Bergschmidt, Philipp; Mittelmeier, Wolfram

    2016-03-01

    Prospectively the outcome after total hip replacement with a new threaded acetabular cup design was compared to an established press-fit cup. After 1, 2 and 5 years, the 36-item Short Form Health Survey, Western Ontario and McMaster University Osteoarthritis Index and Harris Hip Score revealed no significant differences between the two groups (each group: n=42 patients), except for a higher Harris Hip Score in the threaded cup group after five years (p=0.02). After five years, one threaded cup had a mild radiolucent line without further signs of loosening. All other cups of both groups (98.6%) showed a full osseous integration. The cup inclination angle ranged from 41-58° (threaded cups) to 39-77° (press-fit cups). The new threaded cup provides equivalent clinical outcomes and osseous integration but more precise implant positioning compared to the press-fit design. No complications typically ascribed to threaded cups (acetabular fractures, bone resorption, nerve impairment) occurred.

  11. Feasibility of the Atlas Unicompartmental Knee System Load Absorber in Improving Pain Relief and Function in Patients Needing Unloading of the Medial Compartment of the Knee: 1-Year Follow-Up of a Prospective, Multicenter, Single-Arm Pilot Study (PHANTOM High Flex Trial).

    PubMed

    Slynarski, Konrad; Walawski, Jacek; Smigielski, Robert; van der Merwe, Willem

    2017-01-01

    In young patients with medial knee osteoarthritis (OA), surgical intervention may not be desirable due to preferences to avoid bone cutting procedures, return to high activity levels, and prolong implant survival. The Atlas Knee System was designed to fill the gap between ineffective conservative treatments and invasive surgery. This single-arm study included 26 patients, aged 25 to 65 years, who completed 12 months of follow-up. All dimensions of the Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Society Score significantly improved from baseline to 12 months. About 96.2% and 92.3% of patients experienced a ⩾20% improvement in their KOOS pain and WOMAC pain scores, respectively, at 12 months. This study highlights the potential benefit of a joint unloading device in the management of young patients with medial knee OA. The trial is still ongoing and another analysis is planned at 24 months.

  12. The Comprehensive Antibiotic Resistance Database

    PubMed Central

    McArthur, Andrew G.; Waglechner, Nicholas; Nizam, Fazmin; Yan, Austin; Azad, Marisa A.; Baylay, Alison J.; Bhullar, Kirandeep; Canova, Marc J.; De Pascale, Gianfranco; Ejim, Linda; Kalan, Lindsay; King, Andrew M.; Koteva, Kalinka; Morar, Mariya; Mulvey, Michael R.; O'Brien, Jonathan S.; Pawlowski, Andrew C.; Piddock, Laura J. V.; Spanogiannopoulos, Peter; Sutherland, Arlene D.; Tang, Irene; Taylor, Patricia L.; Thaker, Maulik; Wang, Wenliang; Yan, Marie; Yu, Tennison

    2013-01-01

    The field of antibiotic drug discovery and the monitoring of new antibiotic resistance elements have yet to fully exploit the power of the genome revolution. Despite the fact that the first genomes sequenced of free living organisms were those of bacteria, there have been few specialized bioinformatic tools developed to mine the growing amount of genomic data associated with pathogens. In particular, there are few tools to study the genetics and genomics of antibiotic resistance and how it impacts bacterial populations, ecology, and the clinic. We have initiated development of such tools in the form of the Comprehensive Antibiotic Research Database (CARD; http://arpcard.mcmaster.ca). The CARD integrates disparate molecular and sequence data, provides a unique organizing principle in the form of the Antibiotic Resistance Ontology (ARO), and can quickly identify putative antibiotic resistance genes in new unannotated genome sequences. This unique platform provides an informatic tool that bridges antibiotic resistance concerns in health care, agriculture, and the environment. PMID:23650175

  13. Using plain language skills to create an educational brochure about sperm banking for adolescent and young adult males with cancer.

    PubMed

    Nagel, Kim; Wizowski, Lindsay; Duckworth, JoAnn; Cassano, Jane; Hahn, Shirley Ann; Neal, Michael

    2008-01-01

    Writing in plain language makes it easier for patients to read, understand, and make informed decisions about sperm banking. Greater attention to the issue and properly designed educational brochures for use by nurses in oncology and reproductive health is of evident importance but of unknown impact. A multidisciplinary clinical team followed an evidence-based, patient-centered approach to develop "plain language" patient education materials about sperm banking for adolescent and young adult (AYA) males with cancer. A patient education booklet was produced and implemented as part of the planned patient education for AYA male oncology patients at McMaster Children's Hospital, Hamilton Health Sciences, in Hamilton, Ontario, Canada. The patient education booklet for use by health professionals as a teaching tool to facilitate discussion with AYA males has been produced with the hope that it will contribute to better informed decision making regarding sperm banking and increased use of this technology for fertility preservation.

  14. Efficacy and safety of topical Matricaria chamomilla L. (chamomile) oil for knee osteoarthritis: A randomized controlled clinical trial.

    PubMed

    Shoara, Ruhollah; Hashempur, Mohammad Hashem; Ashraf, Alireza; Salehi, Alireza; Dehshahri, Shadab; Habibagahi, Zahra

    2015-08-01

    To assess the efficacy and safety of topical Matricaria chamomilla (Chamomile) oil in patients with knee osteoarthritis. Patients were randomized and treated with topical chamomile oil, diclofenac or placebo, 3 times/day for 3 weeks. They were allowed to use acetaminophen as analgesic. The patients were asked about their total acetaminophen use. Moreover, they were assessed in the terms of pain, physical function and stiffness by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire at the enrolling and weekly. Chamomile oil significantly reduced the patients' need for acetaminophen (P = 0.001) compared with diclofenac and placebo. However, there were no significant differences in WOMAC questionnaire domains. The patients did not report any adverse events by using chamomile oil. Chamomile oil decreased the analgesic demand of patients with knee osteoarthritis. In addition, it may show some beneficial effects on physical function, and stiffness of the patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Comparing Self-Concept Among Youth Currently Receiving Inpatient Versus Outpatient Mental Health Services

    PubMed Central

    Choi, Chris; Ferro, Mark A.

    2018-01-01

    Objective This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Method Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children’s Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. Results The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=−.26; p=.035). Conclusions Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged. PMID:29375635

  16. Comparing Self-Concept Among Youth Currently Receiving Inpatient Versus Outpatient Mental Health Services.

    PubMed

    Choi, Chris; Ferro, Mark A

    2018-01-01

    This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children's Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=-.26; p=.035). Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged.

  17. Comparing Self-Concept Among Youth Currently Receiving Inpatient Versus Outpatient Mental Health Services

    PubMed Central

    Choi, Chris; Ferro, Mark A.

    2018-01-01

    Objective This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Method Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children’s Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. Results The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=−.26; p=.035). Conclusions Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged. PMID:29399020

  18. The opioid manager: a point-of-care tool to facilitate the use of the Canadian Opioid Guideline.

    PubMed

    Furlan, Andrea D; Reardon, Rhoda; Salach, Lena

    2012-01-01

    The Opioid Manager is designed to be used as a point-of-care tool for providers prescribing opioids for chronic noncancer pain. It condenses the key elements from the Canadian Opioid Guideline and can be used as a chart insert. The Opioid Manager has been validated and is available for download from the Guideline's Web site http://nationalpaincentre.mcmaster.ca/opioidmanager/. The Opioid Manager is divided into the following four parts: A) before you write the first script, B) initiation trial, C) maintenance and monitoring, and D) when is it time to decrease the dose or stop the opioid completely? The Opioid Manager has been downloaded by 1,432 users: 47 percent family physicians, 18 percent pharmacists, 13 percent other physicians, and 22 percent miscellaneous. To show how to use the Opioid Manager, the authors created a 10-minute video that is available on the Internet. The Opioid Manager is being translated to French, Spanish, Portuguese, and Farsi.

  19. Preventing ACL injuries in team-sport athletes: a systematic review of training interventions.

    PubMed

    Stojanovic, Marko D; Ostojic, Sergej M

    2012-07-01

    The purpose of this systematic review was to assess the efficacy of training interventions aimed to prevent and to reduce anterior cruciate ligament injury (ACLI) rates in team sport players. We searched MEDLINE from January 1991 to July 2011 using the terms knee, ACL, anterior cruciate ligament, injury, prevention, training, exercise, and intervention. Nine out of 708 articles met the inclusion criteria and were independently rated by two reviewers using the McMaster Occupational Therapy Evidence-Based Practice Research Group scale. Consensus scores ranged from 3 to 8 out of 10. Seven out of nine studies demonstrated that training interventions have a preventive effect on ACLI. Collectively, the studies indicate there is moderate evidence to support the use of multifaceted training interventions, which consisted of stretching, proprioception, strength, plyometric and agility drills with additional verbal and/or visual feedback on proper landing technique to decrease the rate of ACLIs in team sport female athletes, while the paucity of data preclude any conclusions for male athletes.

  20. Comparison of familial and psychological factors in groups of encopresis patients with constipation and without constipation.

    PubMed

    Çengel-Kültür, S Ebru; Akdemir, Devrim; Saltık-Temizel, İnci N

    2014-01-01

    The study aimed to evaluate the differences between groups of encopresis patients with constipation and without constipation. The Symptom Checklist- 90-Revised, the COPE Questionnaire, the Relationship Scales Questionnaire, the McMaster Family Assessment Device and the Parenting Style Scale were used to evaluate, respectively, maternal psychiatric symptoms, coping abilities, attachment style, family functioning and children's perceptions of parenting behaviors. Psychiatric diagnoses were evaluated using the K-SADS. A higher level of maternal psychiatric symptoms, impaired role and affective involvement functioning of the family and less psychological autonomy were observed in the group of encopresis patients with constipation than in the group of encopresis patients without constipation. No significant differences were found between the groups in psychiatric comorbidities, maternal coping abilities and attachment style. The two groups had a similar pattern of comorbid psychiatric disorders and maternal psychological factors, although some familial factors-related mainly to parental authority-were differentiated in the encopresis with constipation group.

  1. Properties of the patient administered questionnaires: new scales measuring physical and psychological symptoms of hip and knee disorders.

    PubMed

    Mancuso, Carol A; Ranawat, Amar S; Meftah, Morteza; Koob, Trevor W; Ranawat, Chitranjan S

    2012-04-01

    The Patient Administered Questionnaires (PAQ) incorporate physical and psychological symptoms into one scale and permit more comprehensive self-reports for hip and knee disorders. We tested the psychometric properties of the PAQ-Hip and PAQ-Knee. Correlations between baseline PAQ-Hip and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were .39 to .72 (n = 102), .39 to .69 for score change (n = 68 post-total hip arthroplasty), and most κ values > .60 (n = 50). Correlations between baseline PAQ-Knee and WOMAC were .35 to .64 (n = 100), .62 to .79 for score change (n = 43 post-total knee arthroplasty), and most κ values >.60 (n = 51). For both scales, effect sizes were higher than for the WOMAC, and there was modest correlation between physical and psychological questions, indicating these concepts are not completely interchangeable. Thus, the PAQ scales have strong psychometric properties and are unique compared with existing scales by including physical and psychological symptoms. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Effects of copper oxide wire particle bolus therapy on trichostrongyle fecal egg counts in exotic artiodactylids.

    PubMed

    Fontenot, Deidre K; Kinney-Moscona, Allyson; Kaplan, Ray M; Miller, James

    2008-12-01

    Four species of artiodactylids (scimitar-horned oryx [Oryx dama]), roan antelope [Hippotragus equinus], blackbuck [Antilope cervicapra]), and blesbok [Damaliscus pygargus phillipsi]) totaling 13 animals were treated with a one-time 12.5-g dose of copper oxide wire particles (COWPs) in a bolus form. Pretreatment, individual trichostrongyle fecal egg counts (FECs) were performed using the McMaster technique. Individual posttreatment FECs were performed every 7 days for 35 days beginning 7 days after bolus administration, and FEC reduction ratios (FECRRs) expressed as percentage reductions from pretreatment values were calculated every 7 days. Mean FECRRs for the 13 animals were 93% +/- 16%, 98% +/- 7%, 91% +/- 28%, 94% +/- 16%, and 90% +/- 13% at 7, 14, 21, 28, and 35 days posttreatment, respectively. These data demonstrate that COWPs in a bolus form were an effective method for reducing FEC in exotic artiodactylids. Based on this limited data, COWPs show promise as an anthelmintic alternative for exotic artiodactylids in zoologic collections.

  3. Design of a high speed business transport

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The design of a High Speed Business Transport (HSBT) was considered by the Aeronautical Design Class during the academic year 1989 to 1990. The project was chosen to offer an opportunity to develop user friendliness for some computer codes such as WAVE DRAG, supplied by NASA/Langley, and to experiment with several design lessons developed by Dr. John McMasters and his colleages at Boeing. Central to these design lessons was an appeal to marketing and feasibility considerations. There was an emphasis upon simplified analytical techniques to study trades and to stimulate creative thinking before committing to extensive analytical activity. Two designs stood out among all the rest because of the depth of thought and consideration of alternatives. One design, the Aurora, used a fixed wing design to satisfy the design mission: the Viero used a swept wing configuration to overcome problems related to supersonic flight. A summary of each of these two designs is given.

  4. Time Burden of Standardized Hip Questionnaires.

    PubMed

    Chughtai, Morad; Khlopas, Anton; Mistry, Jaydev B; Gwam, Chukwuweike U; Elmallah, Randa K; Mont, Michael A

    2016-04-01

    Many standardized scales and questionnaires have been developed to assess outcomes of patients undergoing total hip arthroplasty (THA). However, these surveys can be a burden to both patients and orthopaedists as some are time-inefficient. In addition, there is a paucity of reports assessing the time it takes to complete them. In this study we aimed to: (1) assess how long it takes to complete the most common standardized hip questionnaires; (2) determine the presence of variation in completion time; and (3) evaluate the effects of age, gender, and level of education on completion time. Based on a previous study, we selected the seven most commonly used hip scoring systems-Western Ontario and McMaster Universities Hip Outcome Assessment (WOMAC), Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Larson Score, Short-form 36 (SF-36), modified Merle d'Aubigne and Postel Score (MDA), and Lower Extremity Functional Scale (LEFS). The standardized scales and questionnaires were randomly administered to 70 subjects. The subjects were unaware that they were being timed during completion of the questionnaire. We obtained the coefficients of variation of time for each questionnaire. The mean time to complete the questionnaire was then stratified and compared based on age, gender, and level of education. The mean time to complete each of the systems is listed in ascending order: Modified Merle d'Aubigne and Postel Score (MDA), Lower Extremity Functional Scale (LEFS), Western Ontario and McMaster Universities Hip Outcome Assessment (WOMAC), Harris Hip Score (HHS), Larson Score, Hip Disability and Osteoarthritis Outcome Score (HOOS), and Short-form 36 (SF-36). The WOMAC and Larson Score coefficients of variation were the largest, and the HOOS and MDA were the smallest. There was a significantly higher mean time to completion in those who were above or equal to the age of 55 years as compared to those who were below the age of 55 (227 vs. 166 seconds

  5. Cross-cultural Adaptation and Validation of the Simplified Chinese Version of the Knee Outcome Survey Activities of Daily Living Scale.

    PubMed

    Jia, Zhen-Yu; Wang, Wei; Nian, Xin-Wen; Zhang, Xiao-Xi; Huang, Zhi-Ping; Cui, Jin; Xu, Wei-Dong

    2016-10-01

    To perform a cross-cultural adaptation and translation of the original version of the Activities of Daily Living Scale of the Knee Outcome Survey into Simplified Chinese and validate of the Simplified Chinese version. The original version was translated and cross-culturally adapted into Simplified Chinese according to the guidelines and the recommendations of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 213 patients (96 male, 117 female) were selected to participate in our investigation. The inclusion criteria were as follows: 18 years of age and older, able to speak Chinese Mandarin and read Simplified Chinese, and referred to physical therapy for evaluation and treatment for a knee disorder. The exclusion criteria were as follows: patients who had disorders or impairments involving both knees, patients who had other conditions that could affect lower extremity function, patients with physical therapy related to the knee in the previous 1 month, and patients with psychological problems. Each participant was asked to complete the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS), International Knee Documentation Committee Subjective Knee Form, Western Ontario and McMaster Universities Osteoarthritis Index, and Short Form 36 forms and to provide baseline demographic data. Each participant completed the KOS-ADLS twice on 2 nonconsecutive days for reliability evaluation. A portion of the participants (n = 161) finished the KOS-ADLS a third time 4 weeks after physical treatment to test responsiveness. The original version of the KOS-ADLS was well adapted and translated into Simplified Chinese. Simplified Chinese of KOS-ADLS was shown to have good internal consistency (Cronbach's alpha = 0.855 to 0.929), great test-retest reliability (intraclass correlation coefficient = 0.935 to 0.961), high construct validity as we hypothesized (significant correlations with Short Form 36 subscales, Western Ontario and McMaster

  6. Translation and cross-cultural adaptation of the lower extremity functional scale into a Brazilian Portuguese version and validation on patients with knee injuries.

    PubMed

    Metsavaht, Leonardo; Leporace, Gustavo; Riberto, Marcelo; Sposito, Maria Matilde M; Del Castillo, Letícia N C; Oliveira, Liszt P; Batista, Luiz Alberto

    2012-11-01

    Clinical measurement. To translate and culturally adapt the Lower Extremity Functional Scale (LEFS) into a Brazilian Portuguese version, and to test the construct and content validity and reliability of this version in patients with knee injuries. There is no Brazilian Portuguese version of an instrument to assess the function of the lower extremity after orthopaedic injury. The translation of the original English version of the LEFS into a Brazilian Portuguese version was accomplished using standard guidelines and tested in 31 patients with knee injuries. Subsequently, 87 patients with a variety of knee disorders completed the Brazilian Portuguese LEFS, the Medical Outcomes Study 36-Item Short-Form Health Survey, the Western Ontario and McMaster Universities Osteoarthritis Index, and the International Knee Documentation Committee Subjective Knee Evaluation Form and a visual analog scale for pain. All patients were retested within 2 days to determine reliability of these measures. Validation was assessed by determining the level of association between the Brazilian Portuguese LEFS and the other outcome measures. Reliability was documented by calculating internal consistency, test-retest reliability, and standard error of measurement. The Brazilian Portuguese LEFS had a high level of association with the physical component of the Medical Outcomes Study 36-Item Short-Form Health Survey (r = 0.82), the Western Ontario and McMaster Universities Osteoarthritis Index (r = 0.87), the International Knee Documentation Committee Subjective Knee Evaluation Form (r = 0.82), and the pain visual analog scale (r = -0.60) (all, P<.05). The Brazilian Portuguese LEFS had a low level of association with the mental component of the Medical Outcomes Study 36-Item Short-Form Health Survey (r = 0.38, P<.05). The internal consistency (Cronbach α = .952) and test-retest reliability (intraclass correlation coefficient = 0.957) of the Brazilian Portuguese version of the LEFS were high. The

  7. Inter-rater and test-retest reliability of quality assessments by novice student raters using the Jadad and Newcastle-Ottawa Scales.

    PubMed

    Oremus, Mark; Oremus, Carolina; Hall, Geoffrey B C; McKinnon, Margaret C

    2012-01-01

    Quality assessment of included studies is an important component of systematic reviews. The authors investigated inter-rater and test-retest reliability for quality assessments conducted by inexperienced student raters. Student raters received a training session on quality assessment using the Jadad Scale for randomised controlled trials and the Newcastle-Ottawa Scale (NOS) for observational studies. Raters were randomly assigned into five pairs and they each independently rated the quality of 13-20 articles. These articles were drawn from a pool of 78 papers examining cognitive impairment following electroconvulsive therapy to treat major depressive disorder. The articles were randomly distributed to the raters. Two months later, each rater re-assessed the quality of half of their assigned articles. McMaster Integrative Neuroscience Discovery and Study Program. 10 students taking McMaster Integrative Neuroscience Discovery and Study Program courses. The authors measured inter-rater reliability using κ and the intraclass correlation coefficient type 2,1 or ICC(2,1). The authors measured test-retest reliability using ICC(2,1). Inter-rater reliability varied by scale question. For the six-item Jadad Scale, question-specific κs ranged from 0.13 (95% CI -0.11 to 0.37) to 0.56 (95% CI 0.29 to 0.83). The ranges were -0.14 (95% CI -0.28 to 0.00) to 0.39 (95% CI -0.02 to 0.81) for the NOS cohort and -0.20 (95% CI -0.49 to 0.09) to 1.00 (95% CI 1.00 to 1.00) for the NOS case-control. For overall scores on the six-item Jadad Scale, ICC(2,1)s for inter-rater and test-retest reliability (accounting for systematic differences between raters) were 0.32 (95% CI 0.08 to 0.52) and 0.55 (95% CI 0.41 to 0.67), respectively. Corresponding ICC(2,1)s for the NOS cohort were -0.19 (95% CI -0.67 to 0.35) and 0.62 (95% CI 0.25 to 0.83), and for the NOS case-control, the ICC(2,1)s were 0.46 (95% CI -0.13 to 0.92) and 0.83 (95% CI 0.48 to 0.95). Inter-rater reliability was generally poor

  8. The Effects of Prolotherapy With Hypertonic Dextrose Versus Prolozone (Intraarticular Ozone) in Patients With Knee Osteoarthritis

    PubMed Central

    Hashemi, Masoud; Jalili, Parviz; Mennati, Shirin; Koosha, Alireza; Rohanifar, Ramin; Madadi, Firouz; Razavi, Seyed Sajad; Taheri, Farinaz

    2015-01-01

    Background: Knee osteoarthritis (KOA) is a common disabling disease. Limited studies have demonstrated that prolotherapy with dextrose or with prolozone can be helpful in the treatment of patients with KOA. Objectives: In the current study, we compared the results between these two treatment methods. Patients and Methods: In the current randomized clinical trial, 80 patients with mild to moderate KOA were randomly assigned equally into two groups (ozone group and dextrose group). In each group, injections were repeated three times with 10-day intervals. Before the treatment and 3 months after the injections, the pain intensity was measured by using a visual analogue scale and the Western Ontario and McMaster university arthritis index scores. Finally, the results were compared between the two groups. Results: In the two groups, the pain intensity and WOMAC scores significantly decreased and increased, respectively (P < 0.001). However, there was no significant difference between the two groups. Conclusions: Prolotherapy with dextrose and with prolozone result in the same pain relief or functional improvement in patients with mild to moderate KOA. PMID:26587401

  9. Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients.

    PubMed

    Belcaro, Gianni; Cesarone, Maria Rosaria; Dugall, Mark; Pellegrini, Luciano; Ledda, Andrea; Grossi, Maria Giovanna; Togni, Stefano; Appendino, Giovanni

    2010-12-01

    In a previous three-month study of Meriva, a proprietary curcumin-phosphatidylcholine phytosome complex, decreased joint pain and improvement in joint function were observed in 50 osteoarthritis (OA) patients. Since OA is a chronic condition requiring prolonged treatment, the long-term efficacy and safety of Meriva were investigated in a longer (eight months) study involving 100 OA patients. The clinical end points (Western Ontario and McMaster Universities [WOMAC] score, Karnofsky Performance Scale Index, and treadmill walking performance) were complemented by the evaluation of a series of inflammatory markers (interleukin [IL]-1beta, IL-6, soluble CD40 ligand [sCD40L], soluble vascular cell adhesion molecule (sVCAM)-1, and erythrocyte sedimentation rate [ESR]). This represents the most ambitious attempt, to date, to evaluate the clinical efficacy and safety of curcumin as an anti-inflammatory agent. Significant improvements of both the clinical and biochemical end points were observed for Meriva compared to the control group. This, coupled with an excellent tolerability, suggests that Meriva is worth considering for the long-term complementary management of osteoarthritis.

  10. Strategies for inclusion in play among children with physical disabilities in childcare centers: an integrative review.

    PubMed

    Crawford, Sara K; Stafford, Karen N; Phillips, Sarah M; Scott, Kathleen J; Tucker, Patricia

    2014-11-01

    The purpose of this integrative review was to examine strategies that facilitate inclusion in play among children with physical disabilities in childcare centers. Nine databases were systematically searched for peer reviewed empirical studies investigating inclusion strategies for play in childcare settings among preschoolers with physical disabilities. Nine studies met the inclusion criteria and were appraised using the McMaster Critical Review Forms. The inclusion approaches identified were grouped into relevant strategies during analysis. Two main strategies were identified: role of the adult facilitator and environmental factors. substrategies within the role of the adult facilitator included: customize approach for specific child's needs; adult facilitator self-awareness of presence; prompting and praise; and promote fairness, equity, and play interaction. Substrategies within the environmental factors included: physical setting; type of toys; and type of play activity. The findings suggest play inclusion strategies in the childcare environment. Therapists are encouraged to apply inclusion strategies to improve play opportunities for children with disabilities, but future research is necessary to confirm the effectiveness of these strategies using higher quality study designs.

  11. The Effect of Electrocautery around the Patellar Rim in Patellar Non-Resurfacing Total Knee Arthroplasty

    PubMed Central

    Yim, Soo Jae; Jang, Mun Suk; Kim, Wook Joong; Kang, Hee Kyung

    2012-01-01

    Purpose The purpose of this study was to evaluate the clinical effect of electrocautery on the reduction of pain in patellar non-resurfacing bilateral total knee arthroplasty. Materials and Methods A total of 50 patients were enrolled into this study; all patients had undergone bilateral patellar non-resurfacing total knee arthoplasty at our hospital, between January 2007 to December 2008. The minimum follow-up period was 1 year. The electrocautery of the patellar rim was performed randomly on one side only. The clinical results were evaluated between the electrocautery group and the non-electrocautery group based on measures of anterior knee pain, range of motion, American Knee Society clinical rating score, Feller knee score, Western Ontario and McMaster Universities score, and radiographic analysis. Results There were statistically significant differences between preoperative and postoperative status for all parameters. There were no statistically significant differences noted between the electrocautery group and the non electrocautery group for all parameters. Conclusions Electrocautery of patellar rim is thought to be less effective in reducing anterior knee pain. PMID:22708111

  12. Remote telepresence surgery: the Canadian experience.

    PubMed

    Anvari, M

    2007-04-01

    On 28 February 2003, the world's first telerobotic surgical service was established between St. Joseph's Healthcare Hamilton, a teaching hospital affiliated with McMaster University, and North Bay General Hospital, a community hospital 400 km away. The service was designed to provide telerobotic surgery and assistance by expert surgeons to local surgeons in North Bay, and to improve the range and quality of advanced laparoscopic surgeries offered locally. The two surgeons have collaboratively performed 22 remote telepresence surgeries including laparoscopic fundoplications, laparoscopic colon resections, and laparoscopic inguinal hernia repairs. This article describes the important lessons learned, including the telecommunication requirements, the impact from lack of haptic feedback, surgeons' adaptation to latency, and ethical and medicolegal issues. This is currently the largest clinical experience with assisted robotic telepresence surgery (ARTS) in the world, and the lessons learned will help guide the future design and development of telesurgical robotic platforms. It also will guide the establishment of telesurgical networks connecting various centers in the world, allowing for rapid and safe dissemination of new surgical techniques.

  13. Does clinical presentation predict response to a nonsurgical chronic disease management program for endstage hip and knee osteoarthritis?

    PubMed

    Eyles, Jillian P; Lucas, Barbara R; Patterson, Jillian A; Williams, Matthew J; Weeks, Kate; Fransen, Marlene; Hunter, David J

    2014-11-01

    To identify baseline characteristics of participants who will respond favorably following 6 months of participation in a chronic disease management program for hip and knee osteoarthritis (OA). This prospective cohort study assessed 559 participants at baseline and following 6 months of participation in the Osteoarthritis Chronic Care Program. Response was defined as the minimal clinically important difference of an 18% and 9-point absolute improvement in the Western Ontario and McMaster Universities Arthritis Index global score. Multivariate logistic regression modeling was used to identify predictors of response. Complete data were available for 308 participants. Those who withdrew within the study period were imputed as nonresponders. Three variables were independently associated with response: signal joint (knee vs hip), sex, and high level of comorbidity. Index joint and sex were significant in the multivariate model, but the model was not a sensitive predictor of response. Strong predictors of response to a chronic disease management program for hip and knee OA were not identified. The significant predictors that were found should be considered in future studies.

  14. The effects of progressive neuromuscular training on postural balance and functionality in elderly patients with knee osteoarthritis: a pilot study

    PubMed Central

    Sazo-Rodríguez, Sergio; Méndez-Rebolledo, Guillermo; Guzmán-Muñoz, Eduardo; Rubio-Palma, Paulo

    2017-01-01

    [Purpose] To determine the effects of progressive neuromuscular training on postural balance and functionality in elderly patients with knee osteoarthritis (OA). [Subjects and Methods] Eleven participants between 60 and 75 years of age performed the progressive neuromuscular training for 8 weeks and 4 weeks of follow-up. The area and velocity of the center of pressure were measured on a force platform, and the functionality was measured with a Western Ontario and McMaster Universities Osteoarthritis Index. [Results] The area and velocity (anteroposterior and mediolateral directions) of the center of pressure showed significant differences after 4 and 8 weeks of intervention. Additionally, the global score and some questionnaire dimensions (pain and physical function) showed significant differences after 4 and 8 weeks of intervention. These changes were maintained in all variables at week 4 of follow-up. [Conclusion] The intervention generated improvements in balance and functionality in elderly patients with knee OA. These changes were observed after 4 weeks of training and were maintained 4 weeks after the end of the intervention. PMID:28744054

  15. CARD 2017: expansion and model-centric curation of the comprehensive antibiotic resistance database

    PubMed Central

    Jia, Baofeng; Raphenya, Amogelang R.; Alcock, Brian; Waglechner, Nicholas; Guo, Peiyao; Tsang, Kara K.; Lago, Briony A.; Dave, Biren M.; Pereira, Sheldon; Sharma, Arjun N.; Doshi, Sachin; Courtot, Mélanie; Lo, Raymond; Williams, Laura E.; Frye, Jonathan G.; Elsayegh, Tariq; Sardar, Daim; Westman, Erin L.; Pawlowski, Andrew C.; Johnson, Timothy A.; Brinkman, Fiona S.L.; Wright, Gerard D.; McArthur, Andrew G.

    2017-01-01

    The Comprehensive Antibiotic Resistance Database (CARD; http://arpcard.mcmaster.ca) is a manually curated resource containing high quality reference data on the molecular basis of antimicrobial resistance (AMR), with an emphasis on the genes, proteins and mutations involved in AMR. CARD is ontologically structured, model centric, and spans the breadth of AMR drug classes and resistance mechanisms, including intrinsic, mutation-driven and acquired resistance. It is built upon the Antibiotic Resistance Ontology (ARO), a custom built, interconnected and hierarchical controlled vocabulary allowing advanced data sharing and organization. Its design allows the development of novel genome analysis tools, such as the Resistance Gene Identifier (RGI) for resistome prediction from raw genome sequence. Recent improvements include extensive curation of additional reference sequences and mutations, development of a unique Model Ontology and accompanying AMR detection models to power sequence analysis, new visualization tools, and expansion of the RGI for detection of emergent AMR threats. CARD curation is updated monthly based on an interplay of manual literature curation, computational text mining, and genome analysis. PMID:27789705

  16. Impact of exercise on the functional capacity and pain of patients with knee osteoarthritis: a randomized clinical trial.

    PubMed

    Oliveira, Aline Mizusaki Imoto de; Peccin, Maria Stella; Silva, Kelson Nonato Gomes da; Teixeira, Lucas Emmanuel Pedro de Paiva; Trevisani, Virgínia Fernandes Moça

    2012-12-01

    Muscle weakness, especially of the quadriceps muscle, is one of the major musculoskeletal effects of knee osteoarthritis. Exercises are considered one of the main interventions in the conservative treatment of those patients. To assess the effectiveness of quadriceps strengthening exercises on functional capacity and symptoms related of knee osteoarthritis by use of the Timed Up and Go test (TUG), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lequesne Index. One hundred patients were randomized into two groups: 1) Exercise Group (n = 50), which included stationary bicycle, hamstrings stretching, and quadriceps strengthening; 2) Instruction Group (n = 50), which received a manual with information about knee osteoarthritis and instructions on how to deal with knee symptoms in daily activities. The manual did not include exercise instructions. The Exercise Group showed statistically significant improvement regarding the TUG test, the WOMAC aspects of pain, function, and stiffness, and the Lequesne Index, as compared with the Instruction Group. Quadriceps strengthening exercises for eight weeks are effective to improve pain, function, and stiffness in patients with knee osteoarthritis.

  17. Do Press Ganey Scores Correlate With Total Knee Arthroplasty-Specific Outcome Questionnaires in Postsurgical Patients?

    PubMed

    Chughtai, Morad; Patel, Nirav K; Gwam, Chukwuweike U; Khlopas, Anton; Bonutti, Peter M; Delanois, Ronald E; Mont, Michael A

    2017-09-01

    The purpose of this study was to assess whether Center for Medicaid and Medicare services-implemented satisfaction (Press Ganey [PG]) survey results correlate with established total knee arthroplasty (TKA) assessment tools. Data from 736 patients who underwent TKA and received a PG survey between November 2009 and January 2015 were analyzed. The PG survey overall hospital rating scores were correlated with standardized validated outcome assessment tools for TKA (Short form-12 and 36 Health Survey; Knee Society Score; Western Ontario and McMaster Universities Arthritis Index; University of California, Los Angeles; and visual analog scale) at a mean follow-up of 1154 days post-TKA. There was no correlation between PG survey overall hospital rating score and the above-mentioned outcome assessment tools. Our study shows that there is no statistically significant relationship between established arthroplasty assessment tools and the PG overall hospital rating. Therefore, PG surveys may not be an appropriate tool to determine reimbursement for orthopedists performing TKAs. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Final Technical Report for Award DE-FG02-98ER41080

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chen, Alan

    The prime motivation of the project at McMaster University was to carry out the critical evaluation and compilation of Nuclear Structure and Decay data, and of nuclear astrophysics data with continued participation in the United States Nuclear Data Program (US-NDP). A large body of evaluated and compiled structure data were supplied for databases such as ENSDF, XUNDL, NSR, etc. residing on webpage of National Nuclear Data Center of the Brookhaven National Laboratory, Upton, New York, USA. Thermonuclear reaction rates of importance to stellar explosions, such as novae, x-ray bursts and supernovae, were evaluated as well. This effort was closely coupledmore » to our ongoing experimental effort, which took advantage of radioactive ion beam and stable beam facilities worldwide to study these key reaction rates. This report contains brief descriptions of the various activities together with references to all the publications in peer-reviewed journals which were the result of work carried out with the award DE-FG02-98-ER41080, during 1998-2013.« less

  19. The effect of autologous adipose derived mesenchymal stem cell therapy in the treatment of a large osteochondral defect of the knee following unsuccessful surgical intervention of osteochondritis dissecans - a case study.

    PubMed

    Freitag, Julien; Shah, Kiran; Wickham, James; Boyd, Richard; Tenen, Abi

    2017-07-14

    A prospective analysis of the effect of autologous adipose derived mesenchymal stem cell (MSC) therapy in the treatment of an osteochondral defect of the knee with early progressive osteoarthritis following unsuccessful surgical intervention of osteochondritis dissecans (OCD). After failed conventional management of OCD a patient undergoes intra-articular MSC therapy. Patient outcome measures included the Numeric Pain Rating Scale (NPRS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Structural outcome was assessed using MRI with the novel technique of T2 mapping used to indicate cartilage quality. Following MSC therapy the patient reported improvement in pain and function as measured by NPRS, WOMAC and KOOS. Repeat MRI analysis showed regeneration of cartilage. MRI T2 mapping indicated hyaline like cartilage regrowth. In this report, the use of MSCs, after unsuccessful conventional OCD management, resulted in structural, functional and pain improvement. These results highlight the need to further study the regenerative potential of MSC therapy. Australian and New Zealand Clinical Trial Registry Number - ACTRN12615000258550 (Date registered 19/03/2015 - retrospectively registered).

  20. Inter-rater and test–retest reliability of quality assessments by novice student raters using the Jadad and Newcastle–Ottawa Scales

    PubMed Central

    Oremus, Carolina; Hall, Geoffrey B C; McKinnon, Margaret C

    2012-01-01

    Introduction Quality assessment of included studies is an important component of systematic reviews. Objective The authors investigated inter-rater and test–retest reliability for quality assessments conducted by inexperienced student raters. Design Student raters received a training session on quality assessment using the Jadad Scale for randomised controlled trials and the Newcastle–Ottawa Scale (NOS) for observational studies. Raters were randomly assigned into five pairs and they each independently rated the quality of 13–20 articles. These articles were drawn from a pool of 78 papers examining cognitive impairment following electroconvulsive therapy to treat major depressive disorder. The articles were randomly distributed to the raters. Two months later, each rater re-assessed the quality of half of their assigned articles. Setting McMaster Integrative Neuroscience Discovery and Study Program. Participants 10 students taking McMaster Integrative Neuroscience Discovery and Study Program courses. Main outcome measures The authors measured inter-rater reliability using κ and the intraclass correlation coefficient type 2,1 or ICC(2,1). The authors measured test–retest reliability using ICC(2,1). Results Inter-rater reliability varied by scale question. For the six-item Jadad Scale, question-specific κs ranged from 0.13 (95% CI −0.11 to 0.37) to 0.56 (95% CI 0.29 to 0.83). The ranges were −0.14 (95% CI −0.28 to 0.00) to 0.39 (95% CI −0.02 to 0.81) for the NOS cohort and −0.20 (95% CI −0.49 to 0.09) to 1.00 (95% CI 1.00 to 1.00) for the NOS case–control. For overall scores on the six-item Jadad Scale, ICC(2,1)s for inter-rater and test–retest reliability (accounting for systematic differences between raters) were 0.32 (95% CI 0.08 to 0.52) and 0.55 (95% CI 0.41 to 0.67), respectively. Corresponding ICC(2,1)s for the NOS cohort were −0.19 (95% CI −0.67 to 0.35) and 0.62 (95% CI 0.25 to 0.83), and for the NOS case–control, the ICC(2

  1. Lawson Wilkins: recollections by his daughter

    PubMed Central

    2014-01-01

    Lawson Wilkins is well known as the “father” of the field of pediatric endocrinology, and his scientific accomplishments and legacy are thoroughly documented in this edition and elsewhere. Less well known, though, is what the man himself was like. Here, his daughter, Elizabeth McMaster, recalls the personal side of Dr. Wilkins including his upbringing as the son of a prominent Baltimore doctor, his medical education, establishment of a successful pediatric practice, and eventually the founding of the endocrine clinic at Johns Hopkins. Interwoven with anecdotes and reminiscences, this account provides a vivid sense of Wilkins’ personality and life, from his boisterous nature and devotion to his family and career, to the tragic personal losses he endured. He was a man who threw himself fully into everything he did, whether it was making his own liqueur during Prohibition, collecting specimens from abnormally large circus performers as part of his earliest endocrine research, arranging raucous, impromptu singing parties, sailing the Chesapeake with friends, writing a definitive textbook of Pediatric Endocrinology, training a legion of fellows, or the pioneering work for which he is still known today. PMID:25024712

  2. Optimization of data analysis for the in vivo neutron activation analysis of aluminum in bone.

    PubMed

    Mohseni, H K; Matysiak, W; Chettle, D R; Byun, S H; Priest, N; Atanackovic, J; Prestwich, W V

    2016-10-01

    An existing system at McMaster University has been used for the in vivo measurement of aluminum in human bone. Precise and detailed analysis approaches are necessary to determine the aluminum concentration because of the low levels of aluminum found in the bone and the challenges associated with its detection. Phantoms resembling the composition of the human hand with varying concentrations of aluminum were made for testing the system prior to the application to human studies. A spectral decomposition model and a photopeak fitting model involving the inverse-variance weighted mean and a time-dependent analysis were explored to analyze the results and determine the model with the best performance and lowest minimum detection limit. The results showed that the spectral decomposition and the photopeak fitting model with the inverse-variance weighted mean both provided better results compared to the other methods tested. The spectral decomposition method resulted in a marginally lower detection limit (5μg Al/g Ca) compared to the inverse-variance weighted mean (5.2μg Al/g Ca), rendering both equally applicable to human measurements. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Lawson Wilkins: recollections by his daughter.

    PubMed

    McMaster, Elizabeth Wilkins

    2014-01-01

    Lawson Wilkins is well known as the "father" of the field of pediatric endocrinology, and his scientific accomplishments and legacy are thoroughly documented in this edition and elsewhere. Less well known, though, is what the man himself was like. Here, his daughter, Elizabeth McMaster, recalls the personal side of Dr. Wilkins including his upbringing as the son of a prominent Baltimore doctor, his medical education, establishment of a successful pediatric practice, and eventually the founding of the endocrine clinic at Johns Hopkins. Interwoven with anecdotes and reminiscences, this account provides a vivid sense of Wilkins' personality and life, from his boisterous nature and devotion to his family and career, to the tragic personal losses he endured. He was a man who threw himself fully into everything he did, whether it was making his own liqueur during Prohibition, collecting specimens from abnormally large circus performers as part of his earliest endocrine research, arranging raucous, impromptu singing parties, sailing the Chesapeake with friends, writing a definitive textbook of Pediatric Endocrinology, training a legion of fellows, or the pioneering work for which he is still known today.

  4. Interprofessional education in academic family medicine teaching units: a functional program and culture.

    PubMed

    Price, David; Howard, Michelle; Hilts, Linda; Dolovich, Lisa; McCarthy, Lisa; Walsh, Allyn E; Dykeman, Lynn

    2009-09-01

    The new family health teams (FHTs) in Ontario were designed to enable interprofessional collaborative practice in primary care; however, many health professionals have not been trained in an interprofessional environment. To provide health professional learners with an interprofessional practice experience in primary care that models teamwork and collaborative practice skills. The 2 academic teaching units of the FHT at McMaster University in Hamilton, Ont, employ 6 types of health professionals and provide learning environments for family medicine residents and students in a variety of health care professions. Learners engage in formal interprofessional education activities and mixed professional and learner clinical consultations. They are immersed in an established interprofessional practice environment, where all team members are valued and contribute collaboratively to patient care and clinic administration. Other contributors to the success of the program include the physical layout of the clinics, the electronic medical record communications system, and support from leadership for the additional clinical time commitment of delivering interprofessional education. This academic FHT has developed a program of interprofessional education based partly on planned activities and logistic enablers, and largely on immersing learners in a culture of long-standing interprofessional collaboration.

  5. How does feedback from patients impact upon healthcare student clinical skill development and learning? A systematic review.

    PubMed

    Finch, Emma; Lethlean, Jennifer; Rose, Tanya; Fleming, Jennifer; Theodoros, Deborah; Cameron, Ashley; Coleman, Adele; Copland, David; McPhail, Steven M

    2018-03-01

    A key feature of health professionals' training, irrespective of discipline, is the acquisition and application of clinical and communication skills. Despite this, little is known about the potential role of patient feedback on this process. This systematic review aimed to answer the question: How does feedback from patients impact upon healthcare student clinical skill development and learning? Systematic review of published literature. Electronic databases were searched for studies that explored the effects of patient feedback on student learning and were published before March 2016. Eligible articles underwent methodological evaluation using the McMaster University Critical Evaluation Forms and data extraction. A total of 237 articles were retrieved following searches of electronic databases and hand searches of reference lists. Twelve (7 quantitative, 2 qualitative, 3 mixed methods) studies met the inclusion criteria. Eleven studies reported that patient feedback improved students' clinical skills. Minimal research has explored the impact of patient feedback on student learning. The research to date suggests that direct feedback from patients may be beneficial for the development of students' communication and clinical skills; however, the wide variety of evaluation methods and the lack of validated tools for patients to provide feedback suggest that further exploration is warranted.

  6. Family members' unique perspectives of the family: examining their scope, size, and relations to individual adjustment.

    PubMed

    Jager, Justin; Bornstein, Marc H; Putnick, Diane L; Hendricks, Charlene

    2012-06-01

    Using the McMaster Family Assessment Device (Epstein, Baldwin, & Bishop, 1983) and incorporating the perspectives of adolescent, mother, and father, this study examined each family member's "unique perspective" or nonshared, idiosyncratic view of the family. We used a modified multitrait-multimethod confirmatory factor analysis that (a) isolated for each family member's 6 reports of family dysfunction the nonshared variance (a combination of variance idiosyncratic to the individual and measurement error) from variance shared by 1 or more family members and (b) extracted common variance across each family member's set of nonshared variances. The sample included 128 families from a U.S. East Coast metropolitan area. Each family member's unique perspective generalized across his or her different reports of family dysfunction and accounted for a sizable proportion of his or her own variance in reports of family dysfunction. In addition, after holding level of dysfunction constant across families and controlling for a family's shared variance (agreement regarding family dysfunction), each family member's unique perspective was associated with his or her own adjustment. Future applications and competing alternatives for what these "unique perspectives" reflect about the family are discussed. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  7. Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities.

    PubMed

    Abdel-Aziem, Amr Almaz; Soliman, Elsadat Saad; Mosaad, Dalia Mohammed; Draz, Amira Hussin

    2018-02-01

    [Purpose] To examine the effect of physiotherapy rehabilitation program on moderate knee osteoarthritis in patients with different pain intensities. [Subjects and Methods] Sixty subjects (37 men and 23 women) with moderate knee osteoarthritis participated in the current study. Randomization software was used to select the participating subjects' numbers from the clinic records. They were classified into three groups according to pain intensity: mild, moderate, and severe pain groups. All groups underwent a standard set of pulsed electromagnetic field, ultrasound, stretching exercises, and strengthening exercises. Pain intensity, knee range of motion, knee function, and isometric quadriceps strength were evaluated using the visual analogue scale, universal goniometer, Western Ontario and McMaster Universities osteoarthritis index, and Jamar hydraulic dynamometer, respectively. The evaluation was performed before and after a 4-week rehabilitation program. [Results] All groups showed significant differences in pain intensity, knee range of motion, isometric quadriceps strength, and knee function. The score change in moderate pain group was significantly greater than those in mild and severe pain groups. [Conclusion] Pain intensity is one of the prominent factors that are responsible for the improvement of knee osteoarthritis. Consequently, pain intensity should be considered during rehabilitation of knee osteoarthritis.

  8. Effectiveness of Lower Energy Density Extracorporeal Shock Wave Therapy in the Early Stage of Avascular Necrosis of the Femoral Head.

    PubMed

    Han, Yong; Lee, June-Kyung; Lee, Bong-Yeon; Kee, Hoi-Sung; Jung, Kwang-Ik; Yoon, Seo-Ra

    2016-10-01

    To evaluate the effectiveness of lower energy flux density (EFD) extracorporeal shock wave therapy (ESWT) in the early stage of avascular necrosis (AVN) of the femoral head. Nineteen patients and 30 hips were enrolled. All subjects received 4 weekly sessions of ESWT, at different energy levels; group A (n=15; 1,000 shocks/session, EFD per shock 0.12 mJ/mm 2 ) and group B (n=15; 1,000 shocks/session, EFD per shock 0.32 mJ/mm 2 ). We measured pain by using the visual analog scale (VAS), and disability by using the Harris hip score, Hip dysfunction and Osteoarthritis Outcome Score (HOOS), and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). To determine the effect of the lower EFD ESWT, we assessed the VAS, Harris hip score, HOOS, WOMAC of the subjects before and at 1, 3, and 6 months. In both groups, the VAS, Harris hip score, HOOS, and WOMAC scores improved over time (p<0.05). Lower EFD ESWT may be an effective method to improve the function and to relieve pain in the early stage of AVN.

  9. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

    PubMed Central

    López-Liria, Remedios; Padilla-Góngora, David; Catalan-Matamoros, Daniel; Rocamora-Pérez, Patricia; Pérez-de la Cruz, Sagrario; Fernández-Sánchez, Manuel

    2015-01-01

    Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients' functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The groups did not significantly differ in the leg side (right/left) or clinical characteristics (P > 0.05). After the intervention, both groups showed significant improvements (P < 0.001) from the baseline values in the level of pain (visual analogue scale), the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices), balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective. PMID:25961017

  10. Plasma disposition, concentration in the hair, and anthelmintic efficacy of eprinomectin after topical administration in donkeys.

    PubMed

    Gokbulut, Cengiz; Di Loria, Antonio; Gunay, Necati; Masucci, Roberto; Veneziano, Vincenzo

    2011-12-01

    To investigate plasma disposition, concentration in the hair, and anthelmintic efficacy of eprinomectin after topical administration in donkeys. 12 donkeys naturally infected with strongyle nematodes. The pour-on formulation of eprinomectin approved for use in cattle was administered topically to donkeys at a dosage of 0.5 mg/kg. Heparinized blood samples and hair samples were collected at various times between 1 hour and 40 days after administration. Samples were analyzed via high-performance liquid chromatography with fluorescence detection. Fecal strongyle egg counts were performed by use of a modified McMaster technique before and at weekly intervals for 8 weeks after treatment. Plasma concentration and systemic availability of eprinomectin were relatively higher in donkeys, compared with values reported for other animal species. Concerning the anthelmintic efficacy against strongyle nematodes, eprinomectin was completely effective (100%) on days 7 and 14 and highly effective (> 99%) until the end of the study at 56 days after treatment. No abnormal clinical signs or adverse reactions were observed for any donkeys after treatment. Eprinomectin had excellent safety. The relatively high plasma concentration after topical administration could result in use of eprinomectin for the control and treatment of parasitic diseases in donkeys.

  11. The Saudi clinical practice guideline for the diagnosis of the first deep venous thrombosis of the lower extremity

    PubMed Central

    Al-Hameed, Fahad; Al-Dorzi, Hasan M; Shamy, Abdulrahman; Qadi, Abdulelah; Bakhsh, Ebtisam; Aboelnazar, Essam; Abdelaal, Mohamad; Al Khuwaitir, Tarig; Al-Moamary, Mohamed S.; Al-Hajjaj, Mohamed S.; Brozek, Jan; Schünemann, Holger; Mustafa, Reem; Falavigna, Maicon

    2015-01-01

    The diagnosis of deep venous thrombosis (DVT) may be challenging due to the inaccuracy of clinical assessment and diversity of diagnostic tests. On one hand, missed diagnosis may result in life-threatening conditions. On the other hand, unnecessary treatment may lead to serious complications. As a result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia (KSA), an expert panel led by the Saudi Association for Venous Thrombo-Embolism (SAVTE; a subsidiary of the Saudi Thoracic Society) with the methodological support of the McMaster University Working Group, produced this clinical practice guideline to assist healthcare providers in evidence-based clinical decision-making for the diagnosis of a suspected first DVT of the lower extremity. Twenty-four questions were identified and corresponding recommendations were made following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. These recommendations included assessing the clinical probability of DVT using Wells criteria before requesting any test and undergoing a sequential diagnostic evaluation, mainly using highly sensitive D-dimer by enzyme-linked immunosorbent assay (ELISA) and compression ultrasound. Although venography is the reference standard test for the diagnosis of DVT, its use was not recommended. PMID:25593601

  12. Outcome after cementless total hip arthroplasty for arthritic hip in patients with residual poliomyelitis: a case series.

    PubMed

    Cho, Yoon J; Lee, Choong H; Chun, Young S; Rhyu, Kee H

    2016-09-29

    In this case series, we investigated the outcome of cementless total hip arthroplasty (THA) for advanced hip osteoarthritis in patients with residual poliomyelitis to evaluate its clinical usefulness for these patients. 11 unilateral cementless primary THA were performed to arthritic hips in patients with residual poliomyelitis. 7 were in paralytic and 4 were in nonparalytic limbs. The mean follow-up duration was 79.9 months. Retrospective clinical evaluations with various scores and radiological evaluations were made. Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Short-form (SF)-36 physical scales were significantly improved after the surgery. However, UCLA activity score and SF-36 mental scale were not. Because of remaining leg length discrepancies, all but 1 noted a residual limp. In nonparalytic hip, functional acetabular cup inclination during weight bearing significantly increased from installed inclination. Other than 1 case of posterior dislocation, no complications were observed. Although the overall result itself is excellent, THA for these patients cannot improve limp, physical activity and mental status. Surgeons should be aware of the change of the inclination of acetabular cup during mobilisation, especially for THA in contralateral hip.

  13. Endoparasites of exotic ungulates from the Giraffidae and Camelidae families kept ex situ.

    PubMed

    Nosal, Paweł; Kowal, Jerzy; Kornaś, Sławomir; Wyrobisz, Anna; Skotnicki, Józef; Basiaga, Marta; Plucińska, Natalia E

    2016-01-01

    Giraffes and camels are popular attractions at zoological gardens. In order to present the diversity of parasites infecting exotic ungulates from zoos, faecal samples from three giraffes and six camels from both the Silesian Zoological Garden in Chorzów, and Kraków Zoological Garden, were examined. The research was carried out over a ten-month period in 2013 and 2014. In total, 100 faecal samples from 18 animals were analysed with the use of the McMaster method. Moreover, coccidian oocysts were incubated to investigate their development and larvoscopic examination was conducted to detect the presence of nematode species. Giraffes were infected with coccidia from the genus Eimeria, and gastrointestinal nematodes from the Strongylida order, and Trichuris and Aonhotheca genera. One male giraffe was uninfected. The level of infection in giraffes was low when compared to camels kept in both of the zoos. Limited contact with other animal species contributed greatly to the lower level of infection in camels from Kraków Zoo than those from Chorzów, which were kept in the same enclosure as alpacas and Shetland ponies.

  14. Intestinal helminth infections among inmates in Bedele prison with emphasis on soil-transmitted helminths.

    PubMed

    Terefe, Bahiru; Zemene, Endalew; Mohammed, Abdurehman E

    2015-12-14

    Intestinal helminths infect more than two billion people worldwide. They are common in developing countries where sanitary facilities are inadequate. There is scarcity of documented data on the magnitude of intestinal helminths among inmates in Ethiopia. The aim of this study was to determine prevalence of intestinal helminth infections among inmates in Bedele prison, south-western Ethiopia. A cross-sectional study involving 234 inmates in Bedele prison was conducted in April 2012. Socio-demographic data was collected from each study participant using semi-structured questionnaire. Fresh stool specimens were collected and processed using modified McMaster technique. At least one species of intestinal helminth was identified in 111 (47.4 %) of the inmates. Ascaris lumbricoides was the most predominant parasite isolated, followed by the hookworms. Most of the cases of soil-transmitted helminths (STHs) were light infections. Untrimmed hand fingernails was significantly associated with A. lumbricoides infection (AOR 0.383, 95 % CI 0.200-0.731). Intestinal helminths are common among the inmates in Bedele prison. Health information should be given to the inmates on proper personal hygiene practices with emphasis on trimming of hand fingernails. Monitoring helminth infections in the inmate population is required.

  15. Men and Women Choose Different Careers in Medicine: Causes and Consequences

    PubMed Central

    Ferrier, Barbara M.; Cohen, May; Woodward, Christel A.

    1989-01-01

    Women medical graduates of McMaster University were divided into two groups: those in the fields traditionally chosen by women (primary care, general internal medicine, pediatrics, psychiatry, and anesthesia), and those in nontraditional fields (surgery, subspecialties of medicine, and academic medicine). The careers of the two groups of women were then compared with matched groups of men physicians. More women choosing traditional careers worked in another field, frequently health-related, before deciding to enter medicine than women entering nontraditional careers. Fewer of the former had a university education in the natural sciences, and more of them were married at the start of post-graduate training. Both groups of women worked shorter hours than the comparison groups of men. More women in traditional careers had selected group practice than had the corresponding men. Influences on career choices showed more sex similarities than career-type similarities, with women influenced more by factors related to family responsibilities. Few in any group reported that their choices are not their preferences. The results suggest that complete convergence of the medical careers of men and women in the near future is unlikely. PMID:21248965

  16. Muscle performance, body fat, pain and function in the elderly with arthritis.

    PubMed

    Dos Santos, Wagner Teixeira; Rodrigues, Erika de Carvalho; Mainenti, Míriam Raquel Meira

    2014-01-01

    To correlate muscule performance, body composition, pain and joint function in elderly people with gonarthrosis. 21 elderly patients were submitted to bioelectrical impedance analysis, dynamometry associated with electromyographic (EMG) evaluation of isometric knee extension, in addition to pain assessment by the Numeric Pain Intensity Scale and function assessment, by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis (OA) questionnaire. Correlations were checked by the Pearson's correlation coefficient. The sample characteristics were mean age 67.36 ± 4.21 years old, body fat percentage 40.57±6.15%, total WOMAC score 43.27 ± 16.32%, and maximum strength 19.95 ± 6.99 kgF. Pain during movement showed a statistical association with WOMAC physical activity domain (r = 0.47) and its general score (r = 0.51); pain intensity at night presented association with WOMAC stiffness domain (r = 0.55), in addition to the negative correlation with the slope values of the Medium Frequency of the EMG signal (r = - 0.57). pain intensity is correlated to functional incapacity in elderly people with knee OA and to a greater expression of fatigue in EMG signal. Levels of Evidence III, Study of non consecutive patients.

  17. Tables of X-ray absorption corrections and dispersion corrections: the new versus the old

    NASA Astrophysics Data System (ADS)

    Creagh, Dudley

    1990-11-01

    This paper compares the data on X-ray absorption coefficients calculated by Creagh and Hubbell and tabulated in International Tables for Crystallography, vol. C, ed. A.J.C. Wilson (1990) section 4.2.4 [1] with empirical (Saloman, Hubbell and Scofield, At. Data and Nucl. Data Tables 38 (1988) 1, [6]) and semi-empirical (Hubbell, McMaster, Kerr Del Grande and Mallett, in: International Tables for Crystallography, vol. IV, eds. Ibers and Hamilton (Kynoch, Birmingham, 1974) [2]) tabulations as well as the renormalized relativistic Dirac-Hartree-Fock calculations of Scofield [6]. It also makes comparisons of the real part of the dispersion correction ƒ‧(ω, 0) and tabulated in ref. [1], with theoretical data sets (Cromer and Liberman, J. Chem. Phys. 53 (1970) 1891, and Acta Crystallogr. A37 (1981) 267 [4,5]; Wang, Phys. Rev. A34 (1986) 636 [85]; Kissel, in: Workshop Report on New Dimensions in X-ray Scattering, CONF-870459 (Livermore, 1987) p. 9 [86]) and data collected using a variety of experimental techniques. In both cases the data tabulated in ref. [1] is shown to give improved self-consistency and agreement with experiment.

  18. Cross-cultural adaptation, reliability and validity of the Turkish version of the Hospital for Special Surgery (HSS) Knee Score.

    PubMed

    Narin, Selnur; Unver, Bayram; Bakırhan, Serkan; Bozan, Ozgür; Karatosun, Vasfi

    2014-01-01

    The purpose of this study was to adapt the English version of the Hospital for Special Surgery (HSS) knee score for use in a Turkish population and to evaluate its validity, reliability and cultural adaptation. Standard forward-back translation of the HSS knee score was performed and the Turkish version was applied in 73 patients. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Mini-Mental State Examination and sit-to-stand test were also performed and analyzed. Internal consistency reliability was tested using Cronbach's alpha. The intraclass correlation coefficient (ICC) was used to calculate the test-retest reliability at one-week intervals. Validity was assessed by calculating the Pearson correlation between the HSS, WOMAC and sit-to-stand test scores. The ICC ranged from 0.98 to 0.99 with high internal consistency (Cronbach's alpha: 0.87). The WOMAC score correlated with total HSS score (r: -0.80, p<0.001) and sit-to-stand score (r: 0.12, p: 0.312). The Turkish version of the HSS knee score is reliable and valid in evaluating the total knee arthroplasty in Turkish patients.

  19. Bilateral hip arthroscopy under the same anesthetic for patients with symptomatic bilateral femoroacetabular impingement: 1-year outcomes.

    PubMed

    Mei-Dan, Omer; McConkey, Mark O; Knudsen, Joshua S; Brick, Matthew J

    2014-01-01

    The purpose of this study was to investigate whether, in patients with bilateral symptomatic femoroacetabular impingement, bilateral surgery under 1 anesthetic is safe and efficacious and allows a rapid return of function compared with staged procedures. Three groups were evaluated: in group 1 both hips were treated simultaneously, in group 2 both hips were treated in a staged fashion, and in group 3 a single hip was addressed. The outcome measures were anesthesia and surgical times; time in the hospital; visual analog scale score for pain on postoperative days 1, 3, 7, and 30; analgesic use; and time until the patient could bike, drive, perform office work, perform gym activities, run, and return to play. Midterm evaluation was performed with the Non-Arthritic Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index score at 6 and 12 months postoperatively. We enrolled 76 patients (122 hips) in this study. There were 42 male and 34 female patients. The mean age was 33 years (range, 14 to 50 years), and the mean body mass index was 24 (range, 18 to 35). Group 1 comprised 26 patients (52 hips, 16 male and 10 female patients). Group 2 comprised 20 patients (40 hips, 13 male and 7 female patients), with a mean time between surgeries of 14.56 weeks. Group 3 comprised 33 patients (30 hips, 13 male and 17 female patients). No preoperative differences were found between the groups. The surgical and anesthesia times in group 1 were significantly longer than those in groups 2 and 3. We found no significant differences in postoperative visual analog scale scores, analgesic use, or length of hospital stay. Group 1 required more time before patients were able to ride a stationary bicycle (14.7 days in group 1, 7.8 days in group 2, and 8.5 days in group 3; P < .05). We found no differences between the groups regarding when patients returned to driving, performing office work, or reporting a normal gait. Each group had significant improvements in the Western

  20. The AMS Measurements and Its Applications in Nuclear Physics at China Institute of Atomic Energy (CIAE)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jiang Shan; Shen Hongtao; He Ming

    2010-05-12

    Accelerator Mass Spectrometry (AMS), initiated in late 1970s at McMaster university based on the accelerator and detector technique, has long been applied in the studies on archaeology, geology, and cosmology, as a powerful tool for isotope dating. The advantages of AMS in the analysis of rare nuclides by direct counting of the atoms, small sample size and relatively free from the interferences of molecular ions have been well documented. This paper emphasizes that AMS can not only be used for archaeology, geology, environment, biology and so on, but also served as a unique tool for nuclear physics research. In thismore » paper, the determination of the half-lives of {sup 79}Se, the measurements of the cross-sections of {sup 93}Nb(n,2n){sup 92g}Nb and {sup 238}U(n,3n){sup 236}U reactions, the detection and determination of ultratrace impurities in neutrino detector materials, and the measurement of the fission product nuclide {sup 126}Sn, are to be introduced, as some of examples of AMS applications in nuclear research conducted in AMS lab of China Institute of Atomic Energy. Searching for superheavy nuclides by using AMS is being planned.« less

  1. Associations between physical examination and self-reported physical function in older community-dwelling adults with knee pain.

    PubMed

    Wood, Laurence; Peat, George; Thomas, Elaine; Hay, Elaine M; Sim, Julius

    2008-01-01

    Knee pain is a common disabling condition for which older people seek primary care. Clinicians depend on the history and physical examination to direct treatment. The purpose of this study was to examine the associations between simple physical examination tests and self-reported physical functional limitations. A population sample of 819 older adults underwent a standardized physical examination consisting of 24 tests. Associations between the tests and self-reported physical functional limitations (Western Ontario and McMaster Universities Osteoarthritis Index physical functioning subscale [WOMAC-PF] scores) were explored. Five of the tests showed correlations with WOMAC-PF scores, corresponding to an intermediate effect (r>or=.30). These were tenderness on palpation of the infrapatellar area, timed single-leg standing balance, maximal isometric quadriceps femoris muscle strength (force-generating capacity), reproduction of symptoms on patellofemoral compression, and degree of knee flexion. Each of these tests was able to account for between 7% and 13% of the variance in WOMAC-PF scores, after controlling for age, sex, and body mass index. Three of these tests are indicative of impairments that may be modifiable by exercise interventions. Self-reported physical functional limitations among older people with knee pain are associated with potentially modifiable physical impairments that can be identified by simple physical examination tests.

  2. Conference Committees: Conference Committees

    NASA Astrophysics Data System (ADS)

    2009-09-01

    International Programm Committee (IPC) Harald Ade NCSU Sadao Aoki University Tsukuba David Attwood Lawrence Berkeley National Laboratory/CXRO Christian David Paul Scherrer Institut Peter Fischer Lawrence Berkeley National Laboratory Adam Hitchcock McMaster University Chris Jacobsen SUNY, Stony Brook Denis Joyeux Lab Charles Fabry de l'Institut d'Optique Yasushi Kagoshima University of Hyogo Hiroshi Kihara Kansai Medical University Janos Kirz SUNY Stony Brook Maya Kiskinova ELETTRA Ian McNulty Argonne National Lab/APS Alan Michette Kings College London Graeme Morrison Kings College London Keith Nugent University of Melbourne Zhu Peiping BSRF Institute of High Energy Physics Francois Polack Soleil Christoph Quitmann Paul Scherrer Institut Günther Schmahl University Göttingen Gerd Schneider Bessy Hyun-Joon Shin Pohang Accelerator Lab Jean Susini ESRF Mau-Tsu Tang NSRRC Tony Warwick Lawrence Berkeley Lab/ALS Local Organizing Committee Christoph Quitmann Chair, Scientific Program Charlotte Heer Secretary Christian David Scientific Program Frithjof Nolting Scientific Program Franz Pfeiffer Scientific Program Marco Stampanoni Scientific Program Robert Rudolph Sponsoring, Financials Alfred Waser Industry Exhibition Robert Keller Public Relation Markus Knecht Computing and WWW Annick Cavedon Proceedings and Excursions and Accompanying Persons Program Margrit Eichler Excursions and Accompanying Persons Program Kathy Eikenberry Excursions and Accompanying Persons Program Marlies Locher Excursions and Accompanying Persons Program

  3. Clinical efficacy and safety of mesenchymal stem cell transplantation for osteoarthritis treatment: A meta-analysis

    PubMed Central

    Li, Li; Tao, Sun; Bo, Lin; Lin, Chen

    2017-01-01

    Purpose The aim of this study was to evaluate the therapeutic efficacy and safety of mesenchymal stem cells (MSCs) for the treatment of patients with knee osteoarthritis (OA). Materials We performed a meta-analysis of relevant published clinical studies. An electronic search was conducted for randomized controlled trials (RCTs) of MSC-based therapy in knee OA. The visual analogue scale (VAS), International Knee Documentation Committee (IKDC) form, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne algofunctional indices (Lequesne), Lysholm knee scale (Lysholm), Tegner activity scale (Tegner) and adverse events (AEs) were evaluated. Results Eleven eligible trials with 582 knee OA patients were included in the present meta-analysis. We demonstrated that MSC treatment could significantly decrease VAS and increase IKDC scoresafter a 24-month follow-up compared with controls (P<0.05). MSC therapy also showed significant decreases in WOMAC and Lequesne scores after the 12-month follow-up (P<0.01). Analysis of Lysholm (24-month) and Tegner (12- and 24-month) scores also demonstrated favorable results for MSC treatment (P<0.05). Conclusion Overall, MSC transplantation treatment was shown to be safe and has great potential as an efficacious clinical therapy for patients with knee OA. PMID:28448518

  4. Traditional and Complementary Medicine Use in Knee Osteoarthritis and its Associated Factors Among Patients in Northeast Peninsular Malaysia.

    PubMed

    Nik Shafii, Nik Abdul Hafiz; Yaacob, Lili Husniati; Ishak, Azlina; Kadir, Azidah Abdul

    2018-03-01

    We sought to determine the prevalence of traditional and complementary medicine (TCM) use for knee osteoarthritis and its associated factors among patients attending a referral hospital in an eastern coastal state of Malaysia. This cross-sectional study included 214 patients with knee osteoarthritis. A universal sampling method was applied to patients who attended the outpatient clinic in Hospital Universiti Sains Malaysia from May 2013 to October 2013. Participants were given a questionnaire to determine their sociodemographic information and a validated Bahasa Malaysia version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). This questionnaire was used to assess the severity of knee osteoarthritis (i.e., pain, stiffness, and disturbances in daily activity). Over half (57.9%) of patients reported using TCM to treat knee osteoarthritis. Factors associated with TCM use were gender (odd ratio (OR) = 2.47; 95% confidence interval (CI): 1.28-4.77), duration of knee osteoarthritis (OR = 1.51; 95% CI: 1.03-2.23), and the severity of knee pain (OR = 2.56; 95% CI: 1.71-3.86). The prevalence of TCM use among eastern Malaysian patients with knee osteoarthritis was high. Physicians caring for these patients should be aware of these findings so that inquiries regarding TCM use can be made and patients can be appropriately counseled.

  5. A first-level evaluation of a family intervention for adolescent social, emotional and behavioural difficulties in Child and Adolescent Mental Health Services.

    PubMed

    Wynne, Ciara; Doyle, Caoimhe; Kenny, Rachel; Brosnan, Eileen; Sharry, John

    2016-01-01

    This study is a first-level evaluation of a family intervention targeted at adolescents with social, emotional and behavioural difficulties (SEBD) attending Child and Adolescent Mental Health Services (CAMHS) in Ireland. It is a combined implementation of the Working Things Out adolescent programme and the Parents Plus Adolescent Programme (WTOPPAP). A total of 93 adolescents aged 11-17 years (M = 14.64, SD = 1.31; 39% male) and their parents took part in the study. The study used a quasi-experimental One-Group Pretest-Posttest design to assess change from pre- to post-intervention using the Strengths and Difficulties Questionnaire, the McMaster General Functioning Scale, Goal Attainment, Parent Stress Scale and the Kansas Parenting Satisfaction Scale. Both parent- and adolescent-rated goal attainment and general family functioning improved from pre- to post-intervention. Parents also rated their satisfaction with parenting as having significantly improved. Adolescent-rated emotional difficulties significantly improved for the overall sample and parent-rated child total difficulties for female adolescents significantly improved from pre-test to post-test. Parents of female adolescents also reported a significant drop in parental stress. These findings indicate that the WTOPPAP may be an effective intervention for adolescents with SEBD, particularly females, and their parents. Further implications are discussed.

  6. Three new bachelors of photonics in Ontario

    NASA Astrophysics Data System (ADS)

    Nantel, Marc; Beda, Johann; Grevatt, Treena; Chebbi, Brahim; Jessop, Paul; Song, Shaowen

    2004-10-01

    After the introduction in 2001 of community college programs at the Photonics Technician/Technologist levels, the need to cover the photonics educational space at the undergraduate level was addressed. In the last year, three very different new undergraduate degrees in photonics have started to develop in Ontario. These programs are presented in this paper. The Honours B.Sc. in Photonics at Wilfrid Laurier University (Waterloo) will develop a strong understanding of the theory and application of photonics, with practical hands-on exposure to optics, fibre optics, and lasers. This program benefits from the particularity that the department offering it combines both Physics and Computer Science. At McMaster University, the Engineering Physics program will provide students with a broad background in basic Engineering, Mathematics, Electronics, and Semiconductors, as well as an opportunity to pursue Photonics in greater depth and to have that fact recognized in the program designation. The Niagara and Algonquin College Bachelor of Applied Technology in Photonics program is co-op and joint between the two institutions. Emphasis is placed on the applied aspects of the field, with the more hands-on experimental learning taking precedence in the first years and the more advanced theoretical subjects following in the latter years.

  7. Intestinal parasites of endangered orangutans (Pongo pygmaeus) in Central and East Kalimantan, Borneo, Indonesia.

    PubMed

    Labes, E M; Hegglin, D; Grimm, F; Nurcahyo, W; Harrison, M E; Bastian, M L; Deplazes, P

    2010-01-01

    Faecal samples from 163 captive and semi-captive individuals, 61 samples from wild individuals and 38 samples from captive groups of Bornean orangutans (Pongo pygmaeus) in Kalimantan, Indonesia, were collected during one rainy season (November 2005-May 2006) and screened for intestinal parasites using sodium acetate-acetic acid-formalin-concentration (SAFC), sedimentation, flotation, McMaster- and Baermann techniques. We aimed to identify factors influencing infection risk for specific intestinal parasites in wild orangutans and individuals living in captivity. Various genera of Protozoa (including Entamoeba, Endolimax, Iodamoeba, Balantidium, Giardia and Blastocystis), nematodes (such as Strongyloides, Trichuris, Ascaris, Enterobius, Trichostrongylus and hookworms) and one trematode (a dicrocoeliid) were identified. For the first time, the cestode Hymenolepis was detected in orangutans. Highest prevalences were found for Strongyloides (individuals 37%; groups 58%), hookworms (41%; 58%), Balantidium (40%; 61%), Entamoeba coli (29%; 53%) and a trichostrongylid (13%; 32%). In re-introduction centres, infants were at higher risk of infection with Strongyloides than adults. Infection risk for hookworms was significantly higher in wild males compared with females. In groups, the centres themselves had a significant influence on the infection risk for Balantidium. Ranging patterns of wild orangutans, overcrowding in captivity and a shift of age composition in favour of immatures seemed to be the most likely factors leading to these results.

  8. Effect of home exercise of quadriceps on knee osteoarthritis compared with nonsteroidal antiinflammatory drugs: a randomized controlled trial.

    PubMed

    Doi, Tokuhide; Akai, Masami; Fujino, Keiji; Iwaya, Tsutomu; Kurosawa, Hisashi; Hayashi, Kunihiko; Marui, Eiji

    2008-04-01

    To examine the effect of home-based exercise on knee osteoarthritis among Japanese in comparison with that of nonsteroidal antiinflammatory drugs (NSAIDs). An open-labeled, randomized, controlled, multiclinic trial compared home-based quadriceps exercise with NSAIDs. Treatments were basically evaluated after 8 wks and compared with the baseline scores. Outcomes were evaluated with a set of psychometric measurements including the Western Ontario and McMaster Universities Arthritis Index (WOMAC), 36-Item Short-Form Health Survey (SF-36), Japanese Knee Osteoarthritis Measure (JKOM), and pain with the visual analog scale. A total of 142 patients entered this trial to provide the baseline data. After 21 cases withdrew, the final number analyzed was 121 cases: 63 for the exercise group and 58 for the NSAIDs group. Between these two groups, there was no significant difference in gender, age, body height and weight, body mass index, or each score at baseline. The subjects in both groups showed improvements in all scores at the end of intervention. The difference in improvement rate of each score between the two groups was not statistically significant, though the mean rank score measured with JKOM in the exercise was slightly better than that of the NSAIDs. Home-based exercise using quadriceps strengthening improves knee osteoarthritis no less than NSAIDs.

  9. Radiographic and Functional Outcomes following Knee Arthrodesis Using the Wichita Fusion Nail.

    PubMed

    McQuail, Paula; McCartney, Ben; Baker, Joseph; Green, James; Keogh, Peter; Kenny, Patrick

    2018-05-01

    The purpose of this study was to report both the radiographic and functional outcomes of patients undergoing knee arthrodesis with the Wichita Fusion Nail (WFN) within the Republic of Ireland and compare the results to existing literature. Patient charts and radiographs were reviewed on all patients who had a WFN implanted in Ireland to date. Patients were invited to complete a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score as a functional assessment. Twenty-three patients were identified. Patients had an average of 8 (range: 0-26) knee surgeries prior to arthrodesis. The most common indication was failed arthroplasty due to recalcitrant infection (69.5%). Successful fusion occurred in 60.8% of patients. The mean time to fusion was 9.21 months. The mean WOMAC score was 58.55 with a range of 31 to 96. We found a rate of arthrodesis lower than that reported in other published series. However, the rate of major complications was comparable to those published previously, reflecting the often-challenging patient cohort. Our study shows that the WFN should not be viewed as a near-universally successful option to salvage an unreconstructable knee. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. The Impact of Personality Traits on the Outcome of Total Knee Arthroplasty.

    PubMed

    Giurea, A; Fraberger, G; Kolbitsch, P; Lass, R; Schneider, E; Kubista, B; Windhager, R

    2016-01-01

    Ten to twenty percent of patients with total knee arthroplasty (TKA) are dissatisfied with their clinical outcome. Aim of this study was to investigate the impact of personality traits on the subjective outcome of TKA. We investigated 80 patients with 86 computer navigated TKAs. We asked for patients satisfaction and divided patients into two groups (satisfied or dissatisfied). 12 personality traits were tested by the Freiburg Personality Inventory (FPI-R). Postoperative examination included Knee Society Score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the Visual Analogue Scale (VAS). Radiologic investigation was done in all patients. 84% of our patients were satisfied, while 16% were not satisfied. The FPI-R showed statistical significant influence of four personality traits on patient satisfaction: life satisfaction (p = 0.006), performance orientation (p = 0.015), somatic distress (p = 0.001), and emotional stability (p = 0.002). All clinical scores (VAS, WOMAC, and KSS) showed significantly better results in the satisfied patient. Radiological examination showed optimal alignment of all TKAs. There were no complications requiring revision surgery. The results of our study show that personality traits may influence patients satisfaction and clinical outcome after TKA. Therefore patients personality traits may be a useful predictive factor for postoperative satisfaction after TKA.

  11. [Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise].

    PubMed

    Morgano, Gian Paolo; Davoli, Marina; Moja, Lorenzo; Amato, Laura; Ferroni, Eliana; Tirani, Marcello

    2015-06-01

    Guideline developers worldwide are struggling with the lack of guidance for the practical steps in the guideline enterprise. Our objective was to systematically compile a comprehensive checklist of items linked to relevant resources and tools that guideline developers would consider for development and support of implementation. Data sources included manuals of international guideline developers, literature on guidelines for guidelines with a focus on international and national guideline agencies, professional societies, and recent systematic guidance articles. We reviewed these sources in duplicate, extracted items using a sensitive approach and developed overarching topics that are relevant to guidelines. In an iterative process, we reviewed items for duplication and omissions and involved experts in guideline development for revisions. We developed a checklist with 18 topics and 146 items and a webpage to facilitate its use by guideline developers (http://cebgrade.mcmaster.ca/guidecheck.html). The topics and items included cover all stages of the guideline enterprise, from planning to formulating recommendations, to dissemination and evaluation. The final itemized guideline development checklist (GDC) includes links to training material and resources for methodology. The GDC will serve as a resource for those involved in guideline development and we will use crowdsourcing to keep the checklist up to date and enhance it.

  12. Functional impairment in patients with sporadic Inclusion Body Myositis.

    PubMed

    Dunlap, Heather V; Macneil, Lauren G; Tarnopolsky, Mark A

    2014-03-01

    We conducted a retrospective chart review of 53 patients diagnosed with sporadic Inclusion Body Myositis (sIBM) who have been followed at the McMaster Neuromuscular Clinic since 1996. We reviewed patient medical histories in order to compare our findings with similar cohorts, and analyzed quantitative strength data to determine functionality in guiding decisions related to gait assistive devices. Patient information was acquired through retrospective clinic chart review. Our study found knee extension strength decreased significantly as patients transitioned to using more supportive gait assistive devices (P < 0.05). A decline to below 30 Nm was particularly indicative of the need for a preliminary device (i.e. cane)(P < 0.05). Falls and fear of falling poses a significant threat to patient physical well-being. The prevalence of dysphagia increased as patients required more supportive gait devices, and finally a significant negative correlation was found between time after onset and creatine kinase (CK) levels (P < 0.01). This study supports that knee extension strength may be a useful tool in advising patients concerning ambulatory assistance. Further investigations concerning gait assistive device use and patient history of falling would be beneficial in preventing future falls and improving long-term patient outcomes.

  13. The Impact of Personality Traits on the Outcome of Total Knee Arthroplasty

    PubMed Central

    Giurea, A.; Fraberger, G.; Kolbitsch, P.; Lass, R.; Schneider, E.; Kubista, B.; Windhager, R.

    2016-01-01

    Ten to twenty percent of patients with total knee arthroplasty (TKA) are dissatisfied with their clinical outcome. Aim of this study was to investigate the impact of personality traits on the subjective outcome of TKA. We investigated 80 patients with 86 computer navigated TKAs. We asked for patients satisfaction and divided patients into two groups (satisfied or dissatisfied). 12 personality traits were tested by the Freiburg Personality Inventory (FPI-R). Postoperative examination included Knee Society Score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the Visual Analogue Scale (VAS). Radiologic investigation was done in all patients. 84% of our patients were satisfied, while 16% were not satisfied. The FPI-R showed statistical significant influence of four personality traits on patient satisfaction: life satisfaction (p = 0.006), performance orientation (p = 0.015), somatic distress (p = 0.001), and emotional stability (p = 0.002). All clinical scores (VAS, WOMAC, and KSS) showed significantly better results in the satisfied patient. Radiological examination showed optimal alignment of all TKAs. There were no complications requiring revision surgery. The results of our study show that personality traits may influence patients satisfaction and clinical outcome after TKA. Therefore patients personality traits may be a useful predictive factor for postoperative satisfaction after TKA. PMID:26989686

  14. Femoral neck shortening after internal fixation of a femoral neck fracture.

    PubMed

    Zielinski, Stephanie M; Keijsers, Noël L; Praet, Stephan F E; Heetveld, Martin J; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; Van Lieshout, Esther M M

    2013-07-01

    This study assesses femoral neck shortening and its effect on gait pattern and muscle strength in patients with femoral neck fractures treated with internal fixation. Seventy-six patients from a multicenter randomized controlled trial participated. Patient characteristics and Short Form 12 and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were collected. Femoral neck shortening, gait parameters, and maximum isometric forces of the hip muscles were measured and differences between the fractured and contralateral leg were calculated. Variables of patients with little or no shortening, moderate shortening, and severe shortening were compared using univariate and multivariate analyses. Median femoral neck shortening was 1.1 cm. Subtle changes in gait pattern, reduced gait velocity, and reduced abductor muscle strength were observed. Age, weight, and Pauwels classification were risk factors for femoral neck shortening. Femoral neck shortening decreased gait velocity and seemed to impair gait symmetry and physical functioning. In conclusion, internal fixation of femoral neck fractures results in permanent physical limitations. The relatively young and healthy patients in our study seem capable of compensating. Attention should be paid to femoral neck shortening and proper correction with a heel lift, as inadequate correction may cause physical complaints and influence outcome. Copyright 2013, SLACK Incorporated.

  15. A nanocrystal-based formulation improves the pharmacokinetic performance and therapeutic response of albendazole in dogs.

    PubMed

    Paredes, Alejandro Javier; Litterio, Nicolás; Dib, Alicia; Allemandi, Daniel Alberto; Lanusse, Carlos; Bruni, Sergio Sánchez; Palma, Santiago Daniel

    2018-01-01

    Here, we aimed to assess the pharmacokinetic performance and therapeutic response (anthelmintic efficacy) of an albendazole (ABZ) nano-sized formulation in dogs. In the pharmacokinetic study, ABZ self-dispersible nanocrystals (SDNCS) and a control formulation were administered orally to healthy dogs (n = 6). The concentrations of the sulphoxide metabolite in plasma were determined by high-performance liquid chromatography. For the anthelmintic efficacy trial, SDNCS and a commercially available formulation of ABZ were given to naturally parasitised dogs. The number of Ancylostoma caninum eggs in the faeces was determined using the McMaster technique. The area under the curve, Tmax and Cmax for the SDNCS were improved compared to the control. The efficacy study showed no statistical differences between the SDNCS and the commercial formulation at the doses of 25 and 12.5 mg/kg. However, significant differences (P < 0.05) between the treatments were found at 6.25 mg/kg (a quarter of the reference dose) with a reduction in the faecal nematode egg counts of 62.0 ± 21.1% and 100 ± 0% for the control and SDNCS, respectively. The improved pharmacokinetic performance observed for the novel formulation of ABZ correlated with an improved in vivo therapeutic response against a model intestinal nematode parasite in dogs. © 2017 Royal Pharmaceutical Society.

  16. An open-label six-month extension study to investigate the safety and efficacy of an extract of Artemisia annua for managing pain, stiffness and functional limitation associated with osteoarthritis of the hip and knee.

    PubMed

    Hunt, Sheena; Stebbings, Simon; McNamara, Debra

    2016-10-28

    This six-month single-centre open-label extension study, conducted at the University of Otago, Dunedin, follows from a previously published 12-week pilot double-blind randomised placebo-controlled study of dietary supplement, Arthrem® (ART) in patients with osteoarthritis (OA) of the hip or knee. The pilot double-blind study showed that treatment with ART 150 mg twice-daily was associated with clinically relevant pain reduction. The extension study aims were to assess longer-term safety and efficacy during six months' treatment following the pilot trial. Patients who completed the pilot double-blind study had the option to continue on open-label treatment with ART for a further six months. Safety was assessed by adverse event monitoring and laboratory tests at three and six months. Efficacy was assessed at three and six months using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC®). Thirty-four patients entered the optional extension and 28 completed six months' treatment. ART was well tolerated when taken for up to nine months. Improvements in WOMAC® efficacy parameters reported in the double-blind phase of the study were maintained over six months. ART appears to be a safe and effective alternative for managing the symptoms of OA over an extended period.

  17. Clinical evaluation of the WOMAC 3.0 OA Index in numeric rating scale format using a computerized touch screen version.

    PubMed

    Theiler, R; Spielberger, J; Bischoff, H A; Bellamy, N; Huber, J; Kroesen, S

    2002-06-01

    The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index is a previously described self-administered questionnaire covering three domains: pain, stiffness and function. It has been validated in patients with osteoarthritis (OA) of the hip or knee in a paper-based format. To validate the WOMAC 3.0 using a numerical rating scale in a computerized touch screen format allowing immediate evaluation of the questionnaire. In the computed version cartoons, written and audio instruments were included in order facilitate application. Fifty patients, demographically balanced, with radiographically proven primary hip or knee OA completed the classical paper and the new computerized WOMAC version. Subjects were randomized either to paper format or computerized format first to balance possible order effects. The intra-class correlation coefficients for pain, stiffness and function values were 0.915, 0.745 and 0.940, respectively. The Spearman correlation coefficients for pain, stiffness and function were 0.88, 0.77 and 0.87, respectively. These data indicate that the computerized WOMAC OA index 3.0 is comparable to the paper WOMAC in all three dimensions. The computerized version would allow physicians to get an immediate result and if present a direct comparison with a previous exam. Copyright 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved.

  18. Comparative study of hamstring and quadriceps strengthening treatments in the management of knee osteoarthritis.

    PubMed

    Al-Johani, Ahmed H; Kachanathu, Shaji John; Ramadan Hafez, Ashraf; Al-Ahaideb, Abdulaziz; Algarni, Abdulrahman D; Meshari Alroumi, Abdulmohesn; Alanezi, Aqeel M

    2014-06-01

    [Purpose] Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life (QOL) worldwide. The purpose of this study was to compare exercise treatments for hamstring and quadriceps strength in the management of knee osteoarthritis. [Subjects and Methods] Forty patients with OA knee, aged 50-65 years were divided into 2 groups. The first group (57.65±4.78 years) received hot packs and performed strengthening exercises for the quadriceps and hamstring, and stretching exercises for the hamstring. The second group (58.15±5.11 years) received hot packs and performed strengthening exercises for only the quadriceps, and stretching exercise for the hamstring. Outcome measures were the WOMAC (Western Ontario and McMaster Universities OA index questionnaire), Visual Analogue Scale (VAS) assessment of pain, the Fifty-Foot Walk Test (FWS), and Handheld dynamometry. [Results] There was a significant difference between the groups. The first group showed a more significant result than the second group. [Conclusion] Strengthening of the hamstrings in addition to strengthening of the quadriceps was shown to be beneficial for improving subjective knee pain, range of motion and decreasing the limitation of functional performance of patients with knee osteoarthritis.

  19. The minimal effective dose of cis-9-cetylmyristoleate (CMO) in persons presenting with knee joint pain: A double-blind, randomized, placebo-controlled trial.

    PubMed

    Lee, Sang Chul; Jin, Hyun Seung; Joo, Young; Kim, Yong Chul; Moon, Jee Youn

    2017-03-01

    Nutraceuticals containing cis-9-cetylmyristoleate (CMO) are used to improve knee pain despite the lack of placebo-controlled studies in humans. The aim of the study was to explore the minimal effective dose of CMO for relieving knee joint pain. Twenty-eight subjects with mild degree arthritic knee joint pain were randomized into 4 groups; groups A, B, and C that contained 100%, 80%, and 62.4% of fatty acid component with 12.5% of CMO, and control group D (starch 100%). The pain intensity, functional disability, and the Patient Global Impression of Change (PGIC) were assessed for a 12-week ingestion period. Compared to group D (n = 6), there were significant differences in pain score in group A (n = 7, P = 0.005) and group C (n = 7, P = 0.012), but not significant in group B (n = 6, P = 0.180). Western Ontario and McMaster Universities Arthritis (WOMAC) score decreased significantly in groups A and C. The PGIC was positive in the majority (>50%) in groups A, B, and C, whereas negative in 83.3% in group D (control). CMO is effective in alleviating knee pain in persons with mild degree arthritis of the knee joint, at an effective dose of 62.4%.

  20. Efficacy and safety of Derris scandens Benth extracts in patients with knee osteoarthritis.

    PubMed

    Kuptniratsaikul, Vilai; Pinthong, Theerawut; Bunjob, Malee; Thanakhumtorn, Sunee; Chinswangwatanakul, Pornsiri; Thamlikitkul, Visanu

    2011-02-01

    The objectives of this study were to determine the efficacy and safety of Derris scandens Benth extracts in pain reduction and functional improvement in patients with knee osteoarthritis (OA). This was a prospective, randomized, controlled trial, single-blinded (assessor). The study was conducted at the Rehabilitation Medicine Department, Siriraj Hospital. One hundred and seven (107) patients with primary OA knee who had pain score of ≥ 5 were recruited. Patients were randomized to receive naproxen 500 mg/day or Derris 800 mg/day for 4 weeks. Western Ontario McMaster Osteoarthritis Index (WOMAC) scores and 6-minute walking distance were the outcome measurements. Fifty-five (55) and 52 patients were randomized to Derris and naproxen groups, respectively. The mean differences of all WOMAC scores between 2 groups at week 4 adjusted by week 0 were within ± 1 point. The mean scores of the aforementioned outcomes at weeks 0, 2, and 4 were significantly improved compared to the baseline values. There was no difference of WOMAC scores between groups. The gastrointestinal irritation and dyspepsia were observed more often in the naproxen than in the Derris group. Derris scandens Benth extracts were efficacious and safe for the treatment of knee OA.

  1. Efficacy of oxfendazole and fenbendazole against tortoise (Testudo hermanni) oxyurids.

    PubMed

    Giannetto, S; Brianti, E; Poglayen, G; Sorgi, C; Capelli, G; Pennisi, M G; Coci, G

    2007-04-01

    Thirty-six tortoises (Testudo hermanni) with naturally acquired oxyurids infections were used to assess the anthelmintic efficacy of oxfendazole (Dolthene; Merial) and fenbendazole (Panacur; Hoechst Roussel Vet). Animals were randomly assigned to three groups (A, B, and C) based on sex and weight. Animals in group A (seven males and six females) were orally treated with oxfendazole at dose rate of 66 mg/kg, group B animals (nine males and eight females) were orally treated with fenbendazole at dose rate of 100 mg/kg, and group C animals (three males and three females) were not treated and served as controls. All animals were individually stabled in plexiglas boxes under controlled conditions of temperature, humidity, and light beginning 7 days pretreatment and continuing for the duration of the trial. Individual tortoises feces were examined daily by the McMaster technique and drugs efficacy was assessed by the fecal eggs count reduction (FECR) test. Both drugs showed 100% of FECR. However, oxfendazole reached this level 12 days after treatment, whereas 31 days after treatment were necessary to obtain the same stable result with fenbendazole. The two drugs were well tolerated by all the animals and no adverse reactions were observed after treatment.

  2. Psychological health of military children: Longitudinal evaluation of a family-centered prevention program to enhance family resilience

    PubMed Central

    Lester, Patricia; Stein, Judith A.; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W.; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

    2014-01-01

    Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include: 1) Understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level, and 2) Determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with de-identified service delivery data from 280 families (505 children ages 3-17) in two follow-up assessments. Standardized measures included Service Member and Civilian parental distress (Brief Symptom Inventory, PTSD Checklist – Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families, and suggest areas for future research. PMID:23929043

  3. A manual physical therapy intervention for symptoms of knee osteoarthritis and associated fall risk: A case series of four patients.

    PubMed

    Allen, Chris; Sheehan, Riley; Deyle, Gail; Wilken, Jason; Gill, Norman

    2018-02-26

    Patients with knee osteoarthritis (OA) are at an increased risk of falling. Further, the symptoms associated with knee OA are correlated with fall risk. A manual physical therapy (MPT) approach consisting of mobilizing techniques and reinforcing exercise improves the symptoms and functional limitations associated with knee OA. The purpose of this case series is to evaluate an MPT intervention of mobilization techniques and exercise for knee OA on improving symptoms and quantify the secondary benefit of improving stumble recovery. Four patients with symptomatic knee OA and four matched controls completed a fall risk assessment. Following 4 weeks of intervention, patients were reevaluated. Initial Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores indicated notable symptoms and functional limitations in all patients. In addition, all patients displayed elevated fall risk and/or impaired stumble responses. Following 4 weeks of intervention, all patients reported meaningful reductions in all three WOMAC subscales and demonstrated improvements in at least two of the three fall risk measures. We identified potential connections between symptom relief in patients with knee OA, stumble response, and ultimately fall risk. The results suggest that MPT intervention designed to improve the signs and symptoms of knee OA may lead to a secondary benefit of improved gait stability and stumble response.

  4. The differential impact of clerk interest and participation in a child and adolescent psychiatry clerkship rotation upon psychiatry and pediatrics residency matches.

    PubMed

    Hanson, Mark D; Szatmari, Peter; Eva, Kevin W

    2011-01-01

    The authors evaluated the differential impact of clerk interest and participation in a Child and Adolescent Psychiatry (CAP) clerkship rotation upon psychiatry and pediatrics residency matches. Authors studied clerks from the McMaster University M.D. program graduating years of 2005-2007. Participants were categorized as 1) clerks with CAP clerkship interest and CAP clerkship participation; 2) clerks with CAP clerkship interest but without CAP clerkship participation; and 3) clerks with neither CAP clerkship interest nor CAP clerkship participation. The outcome variable was residency matches, with Psychiatry and Pediatrics residency matches highlighted. Descriptive statistics were used, and chi-squared tests performed to compare proportions of residency matches across these three clerkship groups. Residency matches of 390 clerks were reviewed. CAP clerkship interest was expressed by 23.9% of clerks. Comparison across the two CAP clerkship interest groups revealed match rates to Psychiatry and Pediatrics not to be significantly different, although the proportion of each match was significantly different from the third clerkship group (without CAP clerkship interest) in both instances. CAP clerkship interest, but not participation, was associated with Psychiatry and Pediatrics residency matches. CAP clerkship interest among clerks presents recruitment and educational opportunities; a recruitment opportunity for clerks heading toward a Psychiatry residency, and an educational opportunity for clerks heading toward a Pediatrics residency.

  5. Deficiency of Self-Efficacy in Problem-Solving as a Contributory Factor in Family Instability: A Qualitative Study.

    PubMed

    Pourmovahed, Zahra; Mazloomy Mahmoodabad, Seyed Saied; Zareei Mahmoodabadi, Hassan; Tavangar, Hossein; Yassini Ardekani, Seyed Mojtaba; Vaezi, Ali Akbar

    2018-01-01

    Objective: Problem-solving ability is one of the most important means of family stability that enables the families to understand their roles, functions, and performances. Self-efficacy deficiency in problem-solving runs through many families. This qualitative study was conducted to investigate and describe how couples solve problems in their families. Method: This study was conducted to detect couples' self-efficacy deficiency in problem-solving using purposive sampling method. Several deep semi-structured interviews based on McMaster model and observations were conducted by nine family therapists and psychiatrists on four couples (eight persons) living in Yazd (Iran).The interviews were performed, audio-recorded, and transcribed verbatim. The analysis was interpreted through directed content analysis methods. Results: Families in Yazd (Iran) made some attempts to solve their problems, but their efforts were not enough, and thus they suffered from self-efficacy deficiency, which included 8 categories. The main theme distilled from the data of 17 participants was self-efficacy deficiency, which included the following categories: avoidance, insolvency, interference from others, ineffective self-treatment, behavioral problems, stubbornness, superficiality, and denial. Conclusion: It is of paramount importance to identify self-efficacy deficiency in families and promote problem- solving programs to increase family stability. In the present study, the main deficiencies in problem-solving were detected.

  6. Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid.

    PubMed

    Estades-Rubio, Francisco J; Reyes-Martín, Alvaro; Morales-Marcos, Victor; García-Piriz, Mercedes; García-Vera, Juan J; Perán, Macarena; Marchal, Juan A; Montañez-Heredia, Elvira

    2017-03-17

    Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA) in a single injection with standard preparations of hyaluronic acid (HA) in five injections in osteoarthritis (OA) of the knee. Fifty-four patients with knee osteoarthritis (Kellgren-Lawrence Grade II and III) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane ® ) and Group II with HA (Go-ON ® ). Patient's evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA.

  7. Multidisciplinary assessment measure for individuals with disorders of consciousness.

    PubMed

    Gollega, Ana; Meghji, Chamine; Renton, Sharon; Lazoruk, Arlene; Haynes, Elizabeth; Lawson, Denise; Ostapovitch, MaryAnne

    2015-01-01

    This study introduces the Comprehensive Assessment Measure for the Minimally Responsive Individual (CAMMRI) and reports on its development, inter-rater reliability, construct validity and clinical value. A multidisciplinary team of therapists developed this measure, which comprises 12 sub-tests that examine three main areas: Response to the Environment, Motor Control and Communication and Swallowing. The sub-tests are scored using a 7-point scale; sub-tests can also be administered individually. The measure was administered during a pilot project and then 1 year later to 12 adult clients with severe acquired brain injury at a long-term rehabilitation programme. The age range of the participants was 18-65 years; individuals were 1.5-10 years post-injury. Comparison measures included the Western Neuro Sensory Stimulation Profile (WNSSP), the Coma Recovery Scale-Revised (CRS-R) and the Chedoke McMaster Impairment Inventory (CMII). Inter-rater reliability of each sub-test ranged from 0.87-1.0, with an average of 0.90 in the first year of the assessments. Validity data supported the use of the CAMMRI for minimally conscious adults with ABI to measure behavioural changes and plan treatment for this population. Future research should focus on using this measure with other neurological populations.

  8. Hypertonic dextrose injections (prolotherapy) in the treatment of symptomatic knee osteoarthritis: A systematic review and meta-analysis

    PubMed Central

    Sit, Regina WS; Chung, Vincent CH; Reeves, Kenneth D.; Rabago, David; Chan, Keith KW; Chan, Dicken CC; Wu, Xinyin; Ho, Robin ST; Wong, Samuel YS

    2016-01-01

    Hypertonic dextrose injections (prolotherapy) is an emerging treatment for symptomatic knee osteoarthritis (OA) but its efficacy is uncertain. We conducted a systematic review with meta-analysis to synthesize clinical evidence on the effect of prolotherapy for knee OA. Fifteen electronic databases were searched from their inception to September 2015. The primary outcome of interest was score change on the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Three randomized controlled trials (RCTs) of moderate risk of bias and one quasi–randomized trial were included, with data from a total of 258 patients. In the meta-analysis of two eligible studies, prolotherapy is superior to exercise alone by a standardized mean difference (SMD) of 0.81 (95% CI: 0.18 to 1.45, p = 0.012), 0.78 (95% CI: 0.25 to 1.30, p = 0.001) and 0.62 (95% CI: 0.04 to 1.20, p = 0.035) on the WOMAC composite scale; and WOMAC function and pain subscale scores respectively. Moderate heterogeneity exists in all cases. Overall, prolotherapy conferred a positive and significant beneficial effect in the treatment of knee OA. Adequately powered, longer-term trials with uniform end points are needed to better elucidate the efficacy of prolotherapy. PMID:27146849

  9. A bibliometric analysis of occupational therapy publications.

    PubMed

    Brown, Ted; Gutman, Sharon A; Ho, Yuh-Shan; Fong, Kenneth N K

    2018-01-01

    Bibliometrics involves the statistical analysis of the publications in a specific discipline or subject area. A bibliometric analysis of the occupational therapy refereed literature is needed. A bibliometric analysis was completed of the occupational therapy literature from 1991-2014, indexed in the Science Citation Index-Expanded or the Social Sciences Citation Index. Publications were searched by title, abstract, keywords, and KeyWords Plus. Total number of article citations, citations per journal, and contributions per country, individual authors, and institution were calculated. 5,315 occupational therapy articles were published in 821 journals. It appears that there is a citation window of an approximate 10-year period between the time of publication and the peak number of citations an article receives. The top three most highly cited articles were published in Developmental Medicine and Child Neurology, JAMA, and Lancet. AJOT, BJOT and AOTJ published the largest number of occupational therapy articles with the United States, Australia, and Canada producing the highest number of publications. McMaster University, the University of Queensland, and the University of Toronto were the institutions that published the largest number of occupational therapy journal articles. The occupational therapy literature is growing and the frequency of article citation is increasing.

  10. Infection levels of gastrointestinal parasites in sheep and goats in Papua New Guinea.

    PubMed

    Koinari, M; Karl, S; Ryan, U; Lymbery, A J

    2013-12-01

    Gastrointestinal parasites of livestock cause diseases of important socio-economic concern worldwide. The present study investigated the prevalence of gastrointestinal parasites in sheep and goats in lowland and highland regions of Papua New Guinea (PNG). Faecal samples were collected from a total of 165 small ruminants (110 sheep and 55 goats) from February to April 2011. Analysis by a modified McMaster technique revealed that 128 animals (72% of sheep and 89% of goats) were infected with one or more species of gastrointestinal parasites. The gastrointestinal parasites found and their prevalences in sheep (S) and in goats (G) were as follows: strongyle 67.3% (S), 85.5% (G); Eimeria 17.3% (S), 16.4% (G); Strongyloides, 8.2% (S), 23.6% (G); Fasciola, 5.5% (S), 18.2% (G); Trichuris, 1.8% (S), 3.6% (G); and Nematodirus, 1.8% (S), 3.6% (G). Two additional genera were found in goats: Moniezia (9.1%) and Dictocaulus (3.6%). This is the first study to quantitatively examine the prevalence of gastrointestinal parasites in goats in PNG. The high rates of parasitism observed in the present study are likely to be associated with poor farming management practices, including lack of pasture recovery time, lack of parasite control measures and poor-quality feed.

  11. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study Evaluating Meniscal Healing, Clinical Outcomes, and Safety in Patients Undergoing Meniscal Repair of Unstable, Complete Vertical Meniscal Tears (Bucket Handle) Augmented with Platelet-Rich Plasma.

    PubMed

    Kaminski, Rafal; Kulinski, Krzysztof; Kozar-Kaminska, Katarzyna; Wielgus, Monika; Langner, Maciej; Wasko, Marcin K; Kowalczewski, Jacek; Pomianowski, Stanislaw

    2018-01-01

    The present study aimed to investigate the effectiveness and safety of platelet-rich plasma (PRP) application in arthroscopic repair of complete vertical tear of meniscus located in the red-white zone. This single center, prospective, randomized, double-blind, placebo-controlled, parallel-arm study included 37 patients with complete vertical meniscus tears. Patients received an intrarepair site injection of either PRP or sterile 0.9% saline during an index arthroscopy. The primary endpoint was the rate of meniscus healing in the two groups. The secondary endpoints were changes in the International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and analog scale (VAS) in the two groups at 42 months. After 18 weeks, the meniscus healing rate was significantly higher in the PRP-treated group than in the control group (85% versus 47%, P = 0.048). Functional outcomes were significantly better 42 months after treatment than at baseline in both groups. The IKDC score, WOMAC, and KOOS were significantly better in the PRP-treated group than in the control group. No adverse events were reported during the study period. The findings of this study indicate that PRP augmentation in meniscus repair results in improvements in both meniscus healing and functional outcome.

  12. Influence of post-stroke spasticity on EMG-force coupling and force steadiness in biceps brachii.

    PubMed

    Carlyle, Jennilee K; Mochizuki, George

    2018-02-01

    Individuals with spasticity after stroke experience a decrease in force steadiness which can impact function. Alterations in the strength of EMG-force coupling may contribute to the reduction in force steadiness observed in spasticity. The aim was to determine the extent to which force steadiness and EMG-force coupling is affected by post-stroke spasticity. This cross-sectional study involved individuals with upper limb spasticity after stroke. Participants were required to generate and maintain isometric contractions of the elbow flexors at varying force levels. Coefficient of variation of force, absolute force, EMG-force cross-correlation function peak and peak latency was measured from both limbs with surface electromyography and isometric dynamometry. Statistically significant differences were observed between the affected and less affected limbs for all outcome measures. Significant main effects of force level were also observed. Force steadiness was not statistically significantly correlated with EMG-force coupling; however, both force steadiness and absolute force were associated with the level of impairment as measured by the Chedoke McMaster Stroke Assessment Scale. Spasticity after stroke uncouples the relationship between EMG and force and is associated with reduced force steadiness during isometric contractions; however, these features of control are not associated in individuals with spasticity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Reproducibility and validity of the Dutch translation of the de Morton Mobility Index (DEMMI) used by physiotherapists in older patients with knee or hip osteoarthritis.

    PubMed

    Jans, Marielle P; Slootweg, Vera C; Boot, Cecile R; de Morton, Natalie A; van der Sluis, Geert; van Meeteren, Nico L

    2011-11-01

    To examine the reproducibility, construct validity, and unidimensionality of the Dutch translation of the de Morton Mobility Index (DEMMI), a performance-based measure of mobility for older patients. Cross-sectional study. Rehabilitation center (reproducibility study) and hospital (validity study). Patients (N=28; age >65y) after orthopedic surgery (reproducibility study) and patients (N=219; age >65y) waiting for total hip or total knee arthroplasty (validity study). Not applicable. Not applicable. The intraclass correlation coefficient for interrater reliability was high (.85; 95% confidence interval, 71-.93), and minimal detectable change with 90% confidence was 7 on the 100-point DEMMI scale. Rasch analysis identified that the Dutch translation of the DEMMI is a unidimensional measure of mobility in this population. DEMMI scores showed high correlations with scores on other performance-based measures of mobility (Timed Up and Go test, Spearman r=-.73; Chair Rise Time, r=-.69; walking test, r=.74). A lower correlation of .44 was identified with the self-report measure Western Ontario and McMaster Universities Osteoarthritis Index. The Dutch translation of the DEMMI is a reproducible and valid performance-based measure for assessing mobility in older patients with knee or hip osteoarthritis. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Measuring limitations in activities of daily living: a population-based validation of a short questionnaire.

    PubMed

    Elfering, Achim; Cronenberg, Sonja; Grebner, Simone; Tamcan, Oezguer; Müller, Urs

    2017-12-01

    A newly developed questionnaire assessing limitations in activity of daily living (LADL-Q) that should improve assessment of LADL is tested in a large population-based validation study. This survey was paper-based. Overall, 16,634 individuals who were representative of the working population in the German-speaking part of Switzerland participated in the study. Item analysis was used the final version of the LADL-Q to four items per subscale that correspond to potential problems in three body regions (back and neck, upper extremities, lower extremities). Analysis included tests for reliability, internal consistency, dimensionality and convergent validity. Test-retest reliability coefficients after 2 weeks ranged from 0.82 to 0.99 (Mdn = 0.87), with no item having a coefficient below 0.60. The median item-total coefficients ranged between moderate and good. Correlation coefficients between LADL-Q subscales and three validated clinical instruments (Western Ontario and McMaster Universities osteoarthritis index, shoulder pain disability index, Oswestry) ranged from 0.63 to 0.81. In structural equation modeling the three subscales were significantly related with two important outcomes in occupational rehabilitation: self-reported general health and daily task performance. The new LADL-Q is a brief, reliable and valid tool for assessment of LADL in studies on musculoskeletal health.

  15. Gastrointestinal nematodes in ostriches, Struthio camelus, in different regions of the state of Rio de Janeiro, Brazil.

    PubMed

    Ederli, Nicole Brand; de Oliveira, Francisco Carlos Rodrigues

    2015-01-01

    The ratite group is composed of ostriches, rheas, emus, cassowaries and kiwis. Little research has been done on parasitism in these birds. The aim of this study was to determine the distribution of infections by gastrointestinal nematodes in ostriches in the state of Rio de Janeiro. For this, fecal samples were collected from 192 on 13 farms. From each sample, four grams of feces were used to determine the eggs per gram of feces (EPG) count, by means of the McMaster technique. Part of the feces sample was used for fecal cultures, to identify 100 larvae per sample. The results were subjected to descriptive central trend and dispersion analysis, using confidence intervals at the 5% error probability level in accordance with the Student t distribution, and Tukey's test with a 95% confidence interval. The mean EPG in the state was 1,557, and the municipality of Três Rios had the lowest average (62). The city of Campos dos Goytacazes presented the highest mean EPG of all the municipalities analyzed. The northern region presented the highest mean EPG, followed by the southern, metropolitan, coastal lowland and central regions. Libyostrongylus species were observed on all the farms: L. douglassii predominated, followed by L. dentatus and Codiostomum struthionis.

  16. Families Affected by Huntington's Disease Report Difficulties in Communication, Emotional Involvement, and Problem Solving.

    PubMed

    Jona, Celine M H; Labuschagne, Izelle; Mercieca, Emily-Clare; Fisher, Fiona; Gluyas, Cathy; Stout, Julie C; Andrews, Sophie C

    2017-01-01

    Family functioning in Huntington's disease (HD) is known from previous studies to be adversely affected. However, which aspects of family functioning are disrupted is unknown, limiting the empirical basis around which to create supportive interventions. The aim of the current study was to assess family functioning in HD families. We assessed family functioning in 61 participants (38 HD gene-expanded participants and 23 family members) using the McMaster Family Assessment Device (FAD; Epstein, Baldwin and Bishop, 1983), which provides scores for seven domains of functioning: Problem Solving; Communication; Affective Involvement; Affective Responsiveness; Behavior Control; Roles; and General Family Functioning. The most commonly reported disrupted domain for HD participants was Affective Involvement, which was reported by 39.5% of HD participants, followed closely by General Family Functioning (36.8%). For family members, the most commonly reported dysfunctional domains were Affective Involvement and Communication (both 52.2%). Furthermore, symptomatic HD participants reported more disruption to Problem Solving than pre-symptomatic HD participants. In terms of agreement between pre-symptomatic and symptomatic HD participants and their family members, all domains showed moderate to very good agreement. However, on average, family members rated Communication as more disrupted than their HD affected family member. These findings highlight the need to target areas of emotional engagement, communication skills and problem solving in family interventions in HD.

  17. Families Affected by Huntington’s Disease Report Difficulties in Communication, Emotional Involvement, and Problem Solving

    PubMed Central

    Jona, Celine M.H.; Labuschagne, Izelle; Mercieca, Emily-Clare; Fisher, Fiona; Gluyas, Cathy; Stout, Julie C.; Andrews, Sophie C.

    2017-01-01

    Background: Family functioning in Huntington’s disease (HD) is known from previous studies to be adversely affected. However, which aspects of family functioning are disrupted is unknown, limiting the empirical basis around which to create supportive interventions. Objective: The aim of the current study was to assess family functioning in HD families. Methods: We assessed family functioning in 61 participants (38 HD gene-expanded participants and 23 family members) using the McMaster Family Assessment Device (FAD; Epstein, Baldwin and Bishop, 1983), which provides scores for seven domains of functioning: Problem Solving; Communication; Affective Involvement; Affective Responsiveness; Behavior Control; Roles; and General Family Functioning. Results: The most commonly reported disrupted domain for HD participants was Affective Involvement, which was reported by 39.5% of HD participants, followed closely by General Family Functioning (36.8%). For family members, the most commonly reported dysfunctional domains were Affective Involvement and Communication (both 52.2%). Furthermore, symptomatic HD participants reported more disruption to Problem Solving than pre-symptomatic HD participants. In terms of agreement between pre-symptomatic and symptomatic HD participants and their family members, all domains showed moderate to very good agreement. However, on average, family members rated Communication as more disrupted than their HD affected family member. Conclusion: These findings highlight the need to target areas of emotional engagement, communication skills and problem solving in family interventions in HD. PMID:28968240

  18. Comparative Analysis of Serum Mineral Levels and Parasite Load in Goats Naturally Infected with Gastrointestinal Nematodes.

    PubMed

    Ünübol Aypak, Serap; Aypak, Süleyman; Voyvoda, Hüseyin; Güven, Gülşen; Dereli Fidan, Evrim; Tosun, Gamze; Gültekin, Mehmet; Şimşek, Emrah; Gülçe Güler, Asude

    2016-09-01

    This study aimed to investigate the relationship between serum mineral levels and parasite load in Saanen (n=37) and Damascus (n=13) goats, which were all approximately 2 months pregnant and naturally infected with gastrointestinal nematodes. To determine parasite concentration individually, fecal samples were taken from each goat, and the eggs per gram (EPG) of feces was detected via a modified McMaster technique. To investigate the possible effects of parasite concentration on serum mineral levels, blood was drawn from the goats and serum calcium, phosphorus, magnesium, iron, copper, zinc, manganese, nickel, and cadmium levels were measured via the ICP-OES technique. In a correlation analysis of the individual EPG values and mineral levels performed on the basis of the species, it was seen that increased egg numbers did not cause a statistically significant increase or decrease in Saanens except for cadmium (significant moderate positive correlation, p<0.05) for both species. A comparison of the mineral element levels with the lower and upper normal limits in the published literature found that manganese and iron were below the normal range, while zinc and calcium levels were close to the lower limits. It is estimated that the effect of parasite load, which continuously increases with the progression of pregnancy and deliveries, on blood mineral levels would be much more significant.

  19. The Application of Neutron and X-Ray Techniques to Analyze Works of Art: Examples from The Unvarnished Truth Project

    NASA Astrophysics Data System (ADS)

    MacDonald, Brandi Lee

    2017-01-01

    When considered as an object, a painting consists of multiple components that, when analyzed together, have a unique story to tell about the artist, their practice, and the history of the work of art. Techniques traditionally applied in physics, including neutron-, x-radiographic and near-infrared imaging, and surface elemental analysis via x-ray fluorescence, are useful for generating significant insight into works of art. By examining the supporting material, grounds, pigments, and varnishes that a painter chose to utilize, we generate new knowledge regarding the composition, context, and decision-making involved in the creation of a work. The project `The Unvarnished Truth: exploring the material history of paintings' is an interdisciplinary initiative that incorporated the expertise of forensic art historians, conservation scientists, physicists, and biomedical engineers. Through the technical analysis of nine paintings from the McMaster Museum of Art permanent collection, we explored research questions related to painting technique, attribution, authenticity, connoisseurship, and object condition and stability. The paintings span over 500 years of European art history, and include works from Vincent Van Gogh, Alexander Rodchenko, and A. van der Neer. This project highlights the multitude of ways in which micro- and non-destructive methods can be used to answer art historical questions. This project is supported by grants from Canadian Heritage and Ontario Arts Council.

  20. Developing Mentoring Competency: Does a One Session Training Workshop Have Impact?

    PubMed

    Lau, Chloe; Ford, Jennifer; Van Lieshout, Ryan J; Saperson, Karen; McConnell, Meghan; McCabe, Randi

    2016-06-01

    Mentorship remains vital to the career development, research productivity, and professional advancement of healthcare professionals in all disciplines of academic medicine. Recent studies describe mentor training initiatives aimed at increasing mentoring competency through multisession training curricula. Although the published results of these programs are promising, they require the following: (1) substantial financial resources from the institution, and (2) continuous participation and time commitment from faculty, which may reduce participation and effectiveness. A single, half-day of evidence-based mentor training would represent a more cost-effective and accessible option for educating mentors. The present study investigates the impact of a half-day interactive mentor training workshop on mentoring competency in faculty, staff, and trainees of the Department of Psychiatry and Behavioural Neurosciences at McMaster University. Overall, participants' self-reported mentoring competency mean scores were significantly higher post-workshop compared to pre-workshop ratings [mean = 4.48 vs. 5.02 pre- and post-workshop, respectively; F(1, 31) = 18.386, P < 0.001, η p2 = 0.37]. Survey respondents gave positive feedback and reported greater understanding of mentorship and specific mentoring changes they planned to apply after attending the workshop. Academic and healthcare institutions may use this framework to guide the development of a half-day mentoring workshop into their education programs.

  1. Effects of Self-Knee Massage With Ginger Oil in Patients With Osteoarthritis: An Experimental Study.

    PubMed

    Tosun, Betul; Unal, Nursemin; Yigit, Deniz; Can, Nuray; Aslan, Ozlem; Tunay, Servet

    2017-11-01

    The purpose of our study was to assess the effects of self-knee massage with ginger oil on pain and daily living activities in patients with knee osteoarthritis. Participants (N = 68) were asked about their sociodemographic characteristics, pain level in the last week using the Visual Analog Scale (VAS), and functionality in activities of daily living with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Standard treatment prescribed by a physician was given to the patients with osteoarthritis. In addition to the standard treatment, self-knee massage with ginger oil twice a week was recommended to the intervention group (n = 34). At the end of the first and fifth week, participants in both groups were assessed regarding pain and functional state. The mean VAS Pain scores of the intervention group were significantly lower at the end of the first and fifth weeks (p< .05). The mean total scores and mean Function subscale scores of the WOMAC were significantly lower in massage group in the first- and fifth-week assessments (p < .05). Self-massage of the knee with ginger oil may be used as a complementary method to standard medical treatment. Nurses can easily train patients and their caregivers on knee massage, and the intervention can be implemented by patients at home without any restrictions on location.

  2. Spin frustration and magnetic ordering in triangular lattice antiferromagnet Ca3CoNb2O9

    NASA Astrophysics Data System (ADS)

    Dai, Jia; Zhou, Ping; Wang, Peng-Shuai; Pang, Fei; Munsie, Tim J.; Luke, Graeme M.; Zhang, Jin-Shan; Yu, Wei-Qiang

    2015-12-01

    We synthesized a quasi-two-dimensional distorted triangular lattice antiferromagnet Ca3CoNb2O9, in which the effective spin of Co2+ is 1/2 at low temperatures, whose magnetic properties were studied by dc susceptibility and magnetization techniques. The x-ray diffraction confirms the quality of our powder samples. The large Weiss constant θCW˜ -55 K and the low Neel temperature TN˜ 1.45 K give a frustration factor f = | θCW/TN | ≈ 38, suggesting that Ca3CoNb2O9 resides in strong frustration regime. Slightly below TN, deviation between the susceptibility data under zero-field cooling (ZFC) and field cooling (FC) is observed. A new magnetic state with 1/3 of the saturate magnetization Ms is suggested in the magnetization curve at 0.46 K. Our study indicates that Ca3CoNb2O9 is an interesting material to investigate magnetism in triangular lattice antiferromagnets with weak anisotropy. Project supported by the National Natural Science Foundation of China (Grant Nos. 11374364 and 11222433), the National Basic Research Program of China (Grant No. 2011CBA00112). Research at McMaster University supported by the Natural Sciences and Engineering Research Council. Work at North China Electric Power University supported by the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry.

  3. Use of inpatient continuous passive motion versus no CPM in computer-assisted total knee arthroplasty.

    PubMed

    Alkire, Martha R; Swank, Michael L

    2010-01-01

    Continuous passive motion (CPM) has shown positive effects on tissue healing, edema, hemarthrosis, and joint function (L. Brosseau et al., 2004). CPM has also been shown to increase short-term early flexion and decrease length of stay (LOS) ( L. Brosseau et al., 2004; C. M. Chiarello, C. M. S. Gundersen, & T. O'Halloran, 2004). The benefits of CPM for the population of patients undergoing computer-assisted total knee arthroplasty (TKA) have not been examined. The primary objective of this study was to determine whether the use of CPM following computer-assisted TKA resulted in differences in range of motion, edema/drainage, functional ability, and pain. This was an experimental, prospective, randomized study of patients undergoing unilateral, computer-assisted TKA. The experimental group received CPM thrice daily and physical therapy (PT) twice daily during their hospitalization. The control group received PT twice daily and no CPM during the hospital stay. Both groups received PT after discharge. Measurement included Knee Society scores, Western Ontario McMaster Osteoarthritis Index values, range of motion, knee circumference, and HemoVac drainage. Data were collected at various intervals from preoperatively through 3 months. Although the control group was found to be higher functioning preoperatively, there was no statistically significant difference in flexion, edema or drainage, function, or pain between groups through the 3-month study period.

  4. Correlates of firesetting in a community sample of young adolescents.

    PubMed

    Martin, Graham; Bergen, Helen A; Richardson, Angela S; Roeger, Leigh; Allison, Stephen

    2004-03-01

    To investigate relationships between firesetting, antisocial behaviour, individual, family and parenting factors in a large community sample of adolescents. A cross-sectional study of students (n = 2596) aged 13 years on average, from 27 schools in South Australia with a questionnaire on firesetting, antisocial behaviour (adapted 21-item Self Report Delinquency Scale), risk-taking, drug use, suicidality, physical and sexual abuse, depressive symptomatology, hopelessness, anxiety, locus of control, self-esteem, family functioning (McMaster Family Assessment Device) and parenting style (Influential Relationships Questionnaire). Data analysis included chi2, anova and logistic regression. Large significant differences are found between firesetters and non-firesetters on all measures. Among adolescents with serious levels of antisocial behaviour (7+ acts included in diagnostic guidelines for DSM-IV conduct disorder), firesetters differ from non-firesetters in reporting more extreme antisocial behaviour (10+ acts), extreme drug use, suicidal behaviour, and perceived failure at school. Gender differences are apparent. A study limitation is the single item assessment of firesetting. Self-report firesetting is strongly associated with extreme antisocial behaviour in young community adolescents, in support of existing evidence from incarcerated delinquent and psychiatric populations. Early detection of community firesetters demands further assessment and intervention. Clinicians should consider its coexistence with serious drug use and high risk-taking (especially in girls), and suicidality, sexual and physical abuse (in boys).

  5. Adaptation of the osteoarthritis-specific quality of life scale (the OAQoL) for use in Germany, Hungary, Italy, Spain and Turkey.

    PubMed

    Wilburn, Jeanette; McKenna, Stephen P; Kutlay, Şehim; Bender, Tamas; Braun, Jürgen; Castillo-Gallego, Concepcion; Favero, Marta; Geher, Pal; Kiltz, Uta; Martin-Mola, Emilio; Ramonda, Roberta; Rouse, Matthew; Tennant, Alan; Küçükdeveci, Ayşe A

    2017-05-01

    The Osteoarthritis Quality of Life scale (OAQoL) is specific to individuals with osteoarthritis. The present study describes the adaptation of the OAQoL for use in the following five European languages: German, Hungarian, Italian, Spanish and Turkish. The study involved three stages in each language; translation, cognitive debriefing (face and content validity) and validation. The validation stage assessed internal consistency (Cronbach's alpha), reproducibility (test-retest reliability using Spearman's rank correlations), convergent and divergent validity (correlations with the Health Assessment Questionnaire, The Western Ontario and McMaster Universities Index of osteoarthritis and Nottingham Health Profile) and known group validity. The OAQoL was successfully translated into the target languages with minimal problems. Cognitive debriefing interviewees found the measures easy to complete and identified few problems with content. Internal consistency ranged from 0.94 to 0.97 and test-retest reliability (reproducibility) from 0.87 to 0.98. These values indicate that the new language versions produce very low levels of measurement error. Median OAQoL scores were higher for patients reporting a current flare of osteoarthritis in all countries. Scores were also related, as expected, to perceived severity of osteoarthritis. The OAQoL was successfully adapted for use in Germany, Hungary, Italy, Spain and Turkey. The addition of these new language versions will prove valuable to multinational clinical trials and to clinical practice in the respective countries.

  6. Use and effects of custom-made therapeutic footwear on lower-extremity-related pain and activity limitations in patients with rheumatoid arthritis: A prospective observational study of a cohort.

    PubMed

    Dahmen, Rutger; Buijsmann, Saskia; Siemonsma, Petra C; Boers, Maarten; Lankhorst, Gustaaf J; Roorda, Leo D

    2014-06-01

    An estimated 55-90% of patients with rheumatoid arthritis have foot problems. Therapeutic footwear is frequently prescribed as part of usual care, but data on its use and effect is incomplete. This study aimed to investigate the use and effects of therapeutic footwear. Patients with rheumatoid arthritis receiving custom-made therapeutic footwear for the first time formed an inception cohort. Patients reported their therapeutic footwear use on 3 consecutive days in activity diaries 14 and 20 weeks after delivery of the footwear. The Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) was used as the primary outcome of lower-extremity-related pain and activity limitations, and the Health Assessment Questionnaire (HAQ) as a secondary outcome measure of activity limitations, both at baseline and 26 weeks after therapeutic footwear delivery. The cohort comprised 114 rheumatoid arthritis patients (median disease duration 10 years). Mean (standard deviation) therapeutic footwear use was 54 (25)% of the time patients were out of bed. The median (interquartile range) WOMAC score improved from 41 (27-59) to 31 (16-45) (p < 0.001). Secondary outcome measures improved significantly. Therapeutic footwear was used with moderate intensity by most rheumatoid arthritis patients and was associated with a substantial decrease in pain and activity limitations. Therapeutic footwear is a relevant treatment option for patients with rheumatoid arthritis and foot problems.

  7. Short-term effects of Theracurmin dose and exercise type on pain, walking ability, and muscle function in patients with knee osteoarthritis

    PubMed Central

    Shin, Yun-A; Suk, Min-Hwa; Jang, Hee-Seung; Choi, Hye-Jung

    2017-01-01

    The purpose of this study was to investigate the short-term of Theracurmin dose and exercise type on pain, walking ability, and muscle function in patients with knee osteoarthritis. Twenty-five patients with knee osteoarthritis randomly selected to Theracurmin intake (T) group and Theracurmin in combined with exercise (T+E) group. T group (n= 13) was taken orally a capsule of 700 mg, 3 times per day, (total 2,100 mg, 35 mg/kg-body weight). T+E group (n= 12) performed aerobic training of 30-min walking and weight training for increasing leg muscular strength. After treatment, the number of steps, muscle mass, range of motion of knee, and the muscle strength in flexion and extension significantly increased. The percent body fat, visual analogue scale, The Western Ontario and McMaster score, centers of pressure with closed eye, 10-m walking ability, stair ascending speed were significantly decreased after treatment. Although no difference observed between the T and T+E groups, the 4-week intake of Theracurmin with and without exercise appeared to be effective in reducing the pain and enhancing muscular and balancing function. Therefore, Theracurmin intake for early symptoms and additional exercise as symptoms alleviate might be an effective way of delaying and managing osteoarthritis, and additional studies investigating the effects of Theracurmin and exercise on osteoarthritis could be beneficial. PMID:29326901

  8. Dissecting through barriers: A mixed-methods study on the effect of interprofessional education in a dissection course with healthcare professional students.

    PubMed

    Fernandes, Alisha Rebecca; Palombella, Andrew; Salfi, Jenn; Wainman, Bruce

    2015-01-01

    Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and diminished negative professional stereotypes. An intensive interprofessional gross anatomy dissection course was created in 2009 to facilitate IPE at McMaster University. Data were collected from five cohorts over five years to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions. Each year, 28 students from the medicine, midwifery, nursing, physician's assistant, physiotherapy, and occupational therapy programs were randomly assigned into interprofessional teams for 10 weeks. Sessions involved an anatomy and scope-of-practice presentation, a small-group case-based session, and a dissection. A before/after design measured changes in attitudes and perceptions, while focus group data elaborated on the student experience with the course. Pre- and postmatched data revealed significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative analysis of intraprofessional focus group interviews revealed meaningful improvements in a number of areas including learning anatomy, role clarity, and attitudes towards other health professions. © 2015 American Association of Anatomists.

  9. Traditional and Complementary Medicine Use in Knee Osteoarthritis and its Associated Factors Among Patients in Northeast Peninsular Malaysia

    PubMed Central

    Nik Shafii, Nik Abdul Hafiz; Yaacob, Lili Husniati; Ishak, Azlina; Kadir, Azidah Abdul

    2018-01-01

    Objectives We sought to determine the prevalence of traditional and complementary medicine (TCM) use for knee osteoarthritis and its associated factors among patients attending a referral hospital in an eastern coastal state of Malaysia. Methods This cross-sectional study included 214 patients with knee osteoarthritis. A universal sampling method was applied to patients who attended the outpatient clinic in Hospital Universiti Sains Malaysia from May 2013 to October 2013. Participants were given a questionnaire to determine their sociodemographic information and a validated Bahasa Malaysia version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). This questionnaire was used to assess the severity of knee osteoarthritis (i.e., pain, stiffness, and disturbances in daily activity). Results Over half (57.9%) of patients reported using TCM to treat knee osteoarthritis. Factors associated with TCM use were gender (odd ratio (OR) = 2.47; 95% confidence interval (CI): 1.28–4.77), duration of knee osteoarthritis (OR = 1.51; 95% CI: 1.03–2.23), and the severity of knee pain (OR = 2.56; 95% CI: 1.71–3.86). Conclusions The prevalence of TCM use among eastern Malaysian patients with knee osteoarthritis was high. Physicians caring for these patients should be aware of these findings so that inquiries regarding TCM use can be made and patients can be appropriately counseled. PMID:29657684

  10. A bibliometric analysis of digestive health research in Canada.

    PubMed

    Tuitt, Desiree; Knight, Frank; Lipman, Tara

    2011-11-01

    Measurement of the impact and influence of medical⁄scientific journals, and of individual researchers has become more widely practiced in recent decades. This is driven, in part, by the increased availability of data regarding citations of research articles, and by increased competition for research funding. Digestive disease research has been identified as a particularly strong discipline in Canada. The authors collected quantitative data on the impact and influence of Canadian digestive health research. The present study involved an analysis of the research impact (Hirsch factor) and research influence (Influence factor) of 106 digestive health researchers in Canada. Rankings of the top 25 researchers on the basis of the two metrics were dominated by the larger research groups at the University of Toronto (Toronto, Ontario), McMaster University (Hamilton, Ontario), and the Universities of Calgary (Calgary, Alberta) and Alberta (Edmonton, Alberta), but with representation by other research groups at the Universities of Manitoba (Winnipeg, Manitoba), Western Ontario (London, Ontario) and McGill University (Montreal, Quebec). Female and male researchers had similar scores for the two metrics, as did basic scientists versus clinical investigators. Strategic recruitment, particularly of established investigators, can have a major impact on the ranking of research groups. Comparing these metrics over different time frames can provide insights into the vulnerabilities and strengths of research groups.

  11. Joint laxity and the relationship between muscle strength and functional ability in patients with osteoarthritis of the knee.

    PubMed

    van der Esch, M; Steultjens, M; Knol, D L; Dinant, H; Dekker, J

    2006-12-15

    To establish the impact of knee joint laxity on the relationship between muscle strength and functional ability in osteoarthritis (OA) of the knee. A cross-sectional study of 86 patients with OA of the knee was conducted. Tests were performed to determine varus-valgus laxity, muscle strength, and functional ability. Laxity was assessed using a device that measures the angular deviation of the knee in the frontal plane. Muscle strength was measured using a computer-driven isokinetic dynamometer. Functional ability was assessed by observation (100-meter walking test) and self report (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]). Regression analyses were performed to assess the impact of joint laxity on the relationship between muscle strength and functional ability. In regression analyses, the interaction between muscle strength and joint laxity contributed to the variance in both walking time (P = 0.002) and WOMAC score (P = 0.080). The slope of the regression lines indicated that the relationship between muscle strength and functional ability (walking time, WOMAC) was stronger in patients with high knee joint laxity. Patients with knee OA and high knee joint laxity show a stronger relationship between muscle strength and functional ability than patients with OA and low knee joint laxity. Patients with OA, high knee joint laxity, and low muscle strength are most at risk of being disabled.

  12. Piper aduncum against Haemonchus contortus isolates: cross resistance and the research of natural bioactive compounds.

    PubMed

    Gaínza, Yousmel Alemán; Fantatto, Rafaela Regina; Chaves, Francisco Celio Maia; Bizzo, Humberto Ribeiro; Esteves, Sérgio Novita; Chagas, Ana Carolina de Souza

    2016-01-01

    The anthelminthic activity of the essential oil (EO) of Piper aduncum L. was tested in vitro on eggs and larvae of resistant (Embrapa2010) and susceptible (McMaster) isolates of Haemonchus contortus. The EO was obtained by steam distillation and its components identified by chromatography. EO concentrations of 12.5 to 0.02 mg/mL were used in the egg hatch test (EHT) and concentrations of 3.12 to 0.01 mg/mL in the larval development test (LDT). Inhibition concentrations (IC) were determined by the SAS Probit procedure, and significant differences assessed by ANOVA followed by Tukey's test. In the EHT, the IC50 for the susceptible isolate was 5.72 mg/mL. In the LDT, the IC50 and IC90 were, respectively, 0.10 mg/mL and 0.34 mg/mL for the susceptible isolate, and 0.22 mg/mL and 0.51 mg/mL for the resistant isolate. The EO (dillapiole 76.2%) was highly efficacious on phase L1. Due to the higher ICs obtained for the resistant isolate, it was raised the hypothesis that dillapiole may have a mechanism of action that resembles those of other anthelmintic compounds. We further review and discuss studies, especially those conducted in Brazil, that quantified the major constituents of P. aduncum-derived EO.

  13. Efficacy and safety of flavocoxid, a novel therapeutic, compared with naproxen: a randomized multicenter controlled trial in subjects with osteoarthritis of the knee.

    PubMed

    Levy, Robert M; Khokhlov, Alexander; Kopenkin, Sergey; Bart, Boris; Ermolova, Tatiana; Kantemirova, Raiasa; Mazurov, Vadim; Bell, Marjorie; Caldron, Paul; Pillai, Lakshmi; Burnett, Bruce P

    2010-10-01

    Flavocoxid is a novel flavonoid-based "dual inhibitor" of the 5-lipoxygenase (5-LOX) enzyme and the cyclooxygenase (COX) enzymes. This study was designed to compare the effectiveness and safety of flavocoxid to naproxen in subjects with moderate to severe osteoarthritis (OA) of the knee. In this randomized, multicenter, double-blind study, 220 subjects were assigned to receive either flavocoxid (500 mg twice daily) or naproxen (500 mg twice daily) for 12 weeks. The trial was structured to show noninferiority of flavocoxid to naproxen. Primary outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and subscales and a timed walk. More than 90% of the subjects in both groups noted significant reduction in the signs and symptoms of knee OA. There were no statistically significant differences in efficacy between the flavocoxid and naproxen groups when the entire intent-to-treat population was analyzed. The flavocoxid group had significantly fewer upper gastrointestinal (UGI) and renal (edema) adverse events (AEs) as well as a strong trend toward fewer respiratory AEs. Flavocoxid, a first-in-class flavonoid-based therapeutic that inhibits COX-1 and COX-2 as well as 5-LOX, was as effective as naproxen in managing the signs and symptoms of OA of the knee. Flavocoxid demonstrated better UGI, renal (edema), and respiratory safety profiles than naproxen.

  14. Characteristics and clinical implications of the pharmacokinetic profile of ibuprofen in patients with knee osteoarthritis.

    PubMed

    Gallelli, L; Galasso, O; Urzino, A; Saccà, S; Falcone, D; Palleria, C; Longo, P; Corigliano, A; Terracciano, R; Savino, R; Gasparini, G; De Sarro, G; Southworth, S R

    2012-12-01

    Ibuprofen is a non-selective cyclo-oxygenase (COX)-1/COX-2 inhibitor used to treat pain conditions and inflammation. Limited data have been published concerning the pharmacokinetic profile and clinical effects of ibuprofen in patients with osteoarthritis (OA). In this paper we compared the pharmacokinetic and clinical profile of ibuprofen (at a dosage of from 800 mg/day to 1800 mg/day) administered in patients affected by severe knee OA. Ibuprofen was administered for 7 days to patients who were scheduled to undergo knee arthroplasty due to OA. After 7 days, the ibuprofen concentration in plasma and synovial fluid was measured through both high-performance liquid chromatography (HPLC)-UV and gas chromatography-mass spectroscopy (GC/MS), while clinical effects were evaluated through both visual analogue scale (VAS) and Western Ontario and McMaster Universities (WOMAC) scores. The Naranjo scale and the WHO causality assessment scale were used for estimating the probability of adverse drug reactions (ADRs). The severity of ADRs was assessed by the modified Hartwig and Siegel scale. Ibuprofen showed a dose-dependent diffusion in both plasma and synovial fluid, which was related to the reduction of pain intensity and improvement of health status, without the development of ADRs. Ibuprofen at higher dosages can be expected to provide better control of OA symptoms as a result of higher tissue distribution.

  15. Psychological health of military children: longitudinal evaluation of a family-centered prevention program to enhance family resilience.

    PubMed

    Lester, Patricia; Stein, Judith A; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

    2013-08-01

    Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  16. Variations in the Rate of Infestations of Dogs with Zoonotic Nematodes and the Contamination of Soil in Different Environments.

    PubMed

    Studzińska, Maria Bernadeta; Demkowska-Kutrzepa, Marta; Borecka, Anna; Meisner, Michał; Tomczuk, Krzysztof; Roczeń-Karczmarz, Monika; Kłapeć, Teresa; Abbass, Zahrai; Cholewa, Alicja

    2017-09-01

    Companion animals are an important aspect in human life. However, they may also be considered a source of pathogens. An example of zoonotic parasitoses is toxocarosis or cutaneous larva migrans (CLM). The aim of the study was to detect zoonotic nematodes of dogs living in different areas and the intensity of contamination in parasite polluted environments that are hazardous to human health. The fecal samples were examined using standard flotation and decantation methods as well as McMaster's quantitative technique. The soil samples in urban and rural areas were examined using a modified flotation method as described by Quinn et al. Statistical analyses were performed by IBM SPSS Statistics Version 23. The overall prevalence of parasites in dogs was 38%, 17.02% and 56.60% from urban and rural areas, respectively. The percentage values of nematodes important for human health ( Toxocara canis , Ancylostomatidae, Trichuris vulpis ) remained at the same level (16%). The infected dogs were dominated by a single parasite species, the main was T. canis (28.95%). In total, 54.30% of the soil samples were contaminated with parasite eggs. The contamination of urban and rural sandpits was 40% and 60%, respectively. The molecular examinations of soil samples using LAMP (loop-mediated isothermal amplification) confirmed the presence of nematode eggs of the species T. canis in all samples previously classified as positive.

  17. NEUDOSE: A CubeSat Mission for Dosimetry of Charged Particles and Neutrons in Low-Earth Orbit.

    PubMed

    Hanu, A R; Barberiz, J; Bonneville, D; Byun, S H; Chen, L; Ciambella, C; Dao, E; Deshpande, V; Garnett, R; Hunter, S D; Jhirad, A; Johnston, E M; Kordic, M; Kurnell, M; Lopera, L; McFadden, M; Melnichuk, A; Nguyen, J; Otto, A; Scott, R; Wagner, D L; Wiendels, M

    2017-01-01

    During space missions, astronauts are exposed to a stream of energetic and highly ionizing radiation particles that can suppress immune system function, increase cancer risks and even induce acute radiation syndrome if the exposure is large enough. As human exploration goals shift from missions in low-Earth orbit (LEO) to long-duration interplanetary missions, radiation protection remains one of the key technological issues that must be resolved. In this work, we introduce the NEUtron DOSimetry & Exploration (NEUDOSE) CubeSat mission, which will provide new measurements of dose and space radiation quality factors to improve the accuracy of cancer risk projections for current and future space missions. The primary objective of the NEUDOSE CubeSat is to map the in situ lineal energy spectra produced by charged particles and neutrons in LEO where most of the preparatory activities for future interplanetary missions are currently taking place. To perform these measurements, the NEUDOSE CubeSat is equipped with the Charged & Neutral Particle Tissue Equivalent Proportional Counter (CNP-TEPC), an advanced radiation monitoring instrument that uses active coincidence techniques to separate the interactions of charged particles and neutrons in real time. The NEUDOSE CubeSat, currently under development at McMaster University, provides a modern approach to test the CNP-TEPC instrument directly in the unique environment of outer space while simultaneously collecting new georeferenced lineal energy spectra of the radiation environment in LEO.

  18. Effect of local anaesthetic wound infiltration on acute pain and bleeding after primary total hip arthroplasty: the EDIPO randomised controlled study.

    PubMed

    Villatte, Guillaume; Engels, Emilien; Erivan, Roger; Mulliez, Aurélien; Caumon, Nicolas; Boisgard, Stéphane; Descamps, Stéphane

    2016-11-01

    Total hip arthroplasty (THA) is considered a painful procedure with significant blood loss. The aim of the this study was to determine whether local infiltration analgaesia (LIA) (with long-acting local anaesthetics and epinephrine) during THA could reduce acute postoperative pain, improve early recovery and reduce per- and postoperative bleeding. One hundred and fifty patients scheduled for primary THA were randomised into two groups. The treatment group received LIA (ropivacaine with epinephrine), whereas the control group had no infiltration. Pain intensity was measured with a visual analogue scale (VAS) for the duration of hospital stay and analgaesic consumption. Length of hospital stay, time to get out of bed alone and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index at 3, 6 and 12 months were recorded to evaluate recovery. Per- and postoperative bleeding were evaluated using direct and indirect criteria (operative blood loss, haemoglobin, estimation of uncompensated blood loss and red blood cell transfusion). Patients with LIA had significantly less pain during the first 24 h (p = 0.04). No significant differences were found in terms of analgaesic consumption (p = 0.57), early and delayed recovery or bleeding between groups. Operative wound infiltration of LIA reduced acute pain after primary THA but did not improve recovery or influence per- and postoperative bleeding.

  19. Use of the WOMAC questionnaire in Mumbai and the challenges of translation and cross cultural adaptation.

    PubMed

    Gogtay, N J; Thatte, U M; Dasgupta, B; Deshpande, S

    2013-01-01

    Patient-reported outcome measures (PROMs) are disease specific questionnaires that are being increasingly used in clinical practice and research. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), is a widely used PROM in patients with hip or knee osteoarthritis. A validated WOMAC was used by us, and significant challenges were faced in administering it as several questions did not have a cultural connect. Functionally equivalent items in the Indian context had then to be used to complete the score. With greater emphasis today on the use of patient-reported outcome measures, and with data from multi-centric studies being pooled, cross-cultural adaptation becomes very important if the pooled data are to be really relevant. In India, with several languages being spoken, and a significant proportion of the population being illiterate, the physician and/ or the impartial witness must provide considerable explanation without attempting to influence the response. The key to the effective and correct use of PROMs thus lies not just in translation, but also in a stepwise validation of the questionnaire, and modification in the context of the country where it is used. Scores like WOMAC are often primary efficacy endpoints in clinical trials; are gaining greater importance to support label claims; have ethical implications, and directly impact regulatory decision making and thus, eventually, evidence-based practice.

  20. Collaborative multicenter trials in Latin America: challenges and opportunities in orthopedic and trauma surgery.

    PubMed

    Moraes, Vinicius Ynoe de; Belloti, Joao Carlos; Faloppa, Flavio; Bhandari, Mohit

    2013-01-01

    CONTEXT AND OBJECTIVE Orthopedic research agendas should be considered from a worldwide perspective. Efforts should be planned as the means for obtaining evidence that is valid for health promotion with global outreach. DESIGN AND SETTING Exploratory study conducted at Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil, and McMaster University, Hamilton, Canada. METHODS We identified and analyzed collaborative and multicenter research in Latin America, taking into account American and Canadian efforts as the reference points. We explored aspects of the data available from official sources and used data from traffic accidents as a model for discussing collaborative research in these countries. RESULTS The evaluation showed that the proportion of collaborative and multicenter studies in our setting is small. A brief analysis showed that the death rate due to traffic accidents is very high. Thus, it seems clear to us that initiatives involving collaborative studies are important for defining and better understanding the patterns of injuries resulting from orthopedic trauma and the forms of treatment. Orthopedic research may be an important tool for bringing together orthopedic surgeons, researchers and medical societies for joint action. CONCLUSIONS We have indicated some practical guidelines for initiatives in collaborative research and have proposed some solutions with a summarized plan of action for conducting evidence-based research involving orthopedic trauma.

  1. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study Evaluating Meniscal Healing, Clinical Outcomes, and Safety in Patients Undergoing Meniscal Repair of Unstable, Complete Vertical Meniscal Tears (Bucket Handle) Augmented with Platelet-Rich Plasma

    PubMed Central

    Kulinski, Krzysztof; Kozar-Kaminska, Katarzyna; Wielgus, Monika; Langner, Maciej; Wasko, Marcin K.; Kowalczewski, Jacek; Pomianowski, Stanislaw

    2018-01-01

    Objective The present study aimed to investigate the effectiveness and safety of platelet-rich plasma (PRP) application in arthroscopic repair of complete vertical tear of meniscus located in the red-white zone. Methods This single center, prospective, randomized, double-blind, placebo-controlled, parallel-arm study included 37 patients with complete vertical meniscus tears. Patients received an intrarepair site injection of either PRP or sterile 0.9% saline during an index arthroscopy. The primary endpoint was the rate of meniscus healing in the two groups. The secondary endpoints were changes in the International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and analog scale (VAS) in the two groups at 42 months. Results After 18 weeks, the meniscus healing rate was significantly higher in the PRP-treated group than in the control group (85% versus 47%, P = 0.048). Functional outcomes were significantly better 42 months after treatment than at baseline in both groups. The IKDC score, WOMAC, and KOOS were significantly better in the PRP-treated group than in the control group. No adverse events were reported during the study period. Conclusions The findings of this study indicate that PRP augmentation in meniscus repair results in improvements in both meniscus healing and functional outcome. PMID:29713647

  2. Chinese adaptation and validation of the patellofemoral pain severity scale.

    PubMed

    Cheung, Roy T H; Ngai, Shirley P C; Lam, Priscillia L; Chiu, Joseph K W; Fung, Eric Y H

    2013-05-01

    This study validated the Patellofemoral Pain Severity Scale translated into Chinese. The Chinese Patellofemoral Pain Severity Scale was translated from the original English version following standard forward and backward translation procedures recommended by the International Society for Pharmacoeconomics and Outcomes Research. The survey was then conducted in clinical settings by a questionnaire comprising the Chinese Patellofemoral Pain Severity Scale, Kujala Scale and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Eighty-four Chinese reading patients with patellofemoral pain were recruited from physical therapy clinics. Internal consistency of the translated instrument was measured by Cronbach alpha. Convergent validity was examined by Spearman rank correlation coefficient (rho) tests by comparing its score with the validated Chinese version of the Kujala Scale and the WOMAC Osteoarthritis Index while the test-retest reliability was evaluated by administering the questionnaires twice. Cronbach alpha values of individual questions and their overall value were above 0.85. Strong association was found between the Chinese Patellofemoral Pain Severity Scale and the Kujala Scale (rho = -0.72, p < 0.001). Moderate correlation was also found between Chinese Patellofemoral Pain Severity Scale with the WOMAC Osteoarthritis Index (rho = 0.63, p < 0.001). Excellent test-retest reliability (Intraclass correlation coefficient = 0.98) was demonstrated. The Chinese translated version of the Patellofemoral Pain Severity Scale is a reliable and valid instrument for patients with patellofemoral pain.

  3. Analysis of the reliability and validity of the Turkish version of the intermittent and constant osteoarthritis pain questionnaire.

    PubMed

    Erel, Suat; Şimşek, İbrahim Engin; Özkan, Hüseyin

    2015-01-01

    The aim of this study was to analyze the validity and reliability of the Turkish version (ICOAP-TR) of the intermittent and constant osteoarthritis pain (ICOAP) questionnaire in patients with knee osteoarthritis (OA). Thirty-eight volunteer patients diagnosed with knee OA answered the questionnaire twice with an interval of 2-4 days. The reliability of the measurement was assessed using Cronbach's alpha coefficient and intraclass correlation (ICC) for test-retest reliability. Criterion validity was tested against the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score and visual analog scale (VAS) designed to assess the perceived discomfort rated by the patient. Test-retest reliability was found to be ICC=0.942 for total score, 0.902 for constant pain subscale, and 0.945 for intermittent pain subscale. Internal consistency was tested using Cronbach's alpha and was found to be 0.970 for total score, 0.948 for constant pain subscale, and 0.972 for intermittent pain subscale. For criterion validity, the correlation between the total score of ICOAP-TR and WOMAC pain subscale was r=0.779 (p<0.05), and correlation between total score of ICOAP-TR and VAS was r=0.570 (p<0.05). The ICOAP-TR is a reliable and valid instrument to be used with patients with knee OA.

  4. Validating Self-Report Measures of Pain and Function in Patients Undergoing Hip or Knee Arthroplasty

    PubMed Central

    Dogra, Moneet; Woodhouse, Linda; Kennedy, Deborah M.; Spadoni, Greg F.

    2009-01-01

    ABSTRACT Purpose: To investigate the factorial and construct validity of a four-item pain intensity scale, the P4, in patients awaiting primary total hip or knee arthroplasty secondary to osteoarthritis. Method: A construct validation design was applied to a sample of convenience of 117 patients (mean age 65.6 [SD = 11.2] years) at their preoperative visit. All patients completed the P4 and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Exploratory and confirmatory factor analyses were used to examine the factorial structure of the P4 and WOMAC. To evaluate construct validity, we examined the correlation between the P4 and WOMAC pain sub-scales and the ability of the P4 to differentiate between patients awaiting hip and knee replacement. Results: Two distinct factors consistent with the themes of pain and function were identified with P4 and WOMAC physical function items, but not with the WOMAC pain and physical function items. The P4 correlates more with the WOMAC pain scores (r = 0.67) than with the WOMAC physical function scores (r = 0.60). Conclusion: The P4's validity was supported in this patient group. The use of the P4 with the WOMAC physical function sub-scale provides a more distinct assessment of pain and function than the WOMAC pain and physical function scales. PMID:20808479

  5. Prediction of citation counts for clinical articles at two years using data available within three weeks of publication: retrospective cohort study

    PubMed Central

    2008-01-01

    Objective To determine if citation counts at two years could be predicted for clinical articles that pass basic criteria for critical appraisal using data within three weeks of publication from external sources and an online article rating service. Design Retrospective cohort study. Setting Online rating service, Canada. Participants 1274 articles from 105 journals published from January to June 2005, randomly divided into a 60:40 split to provide derivation and validation datasets. Main outcome measures 20 article and journal features, including ratings of clinical relevance and newsworthiness, routinely collected by the McMaster online rating of evidence system, compared with citation counts at two years. Results The derivation analysis showed that the regression equation accounted for 60% of the variation (R2=0.60, 95% confidence interval 0.538 to 0.629). This model applied to the validation dataset gave a similar prediction (R2=0.56, 0.476 to 0.596, shrinkage 0.04; shrinkage measures how well the derived equation matches data from the validation dataset). Cited articles in the top half and top third were predicted with 83% and 61% sensitivity and 72% and 82% specificity. Higher citations were predicted by indexing in numerous databases; number of authors; abstraction in synoptic journals; clinical relevance scores; number of cited references; and original, multicentred, and therapy articles from journals with a greater proportion of articles abstracted. Conclusion Citation counts can be reliably predicted at two years using data within three weeks of publication. PMID:18292132

  6. Cross-cultural adaptation and validation of the Turkish version of Oxford hip score.

    PubMed

    Tuğay, Baki Umut; Tuğay, Nazan; Güney, Hande; Hazar, Zeynep; Yüksel, İnci; Atilla, Bülent

    2015-06-01

    The purpose of this study was to translate the Oxford hip score (OHS) into Turkish and to evaluate the psychometric properties by testing the internal consistency, reproducibility, construct validity, and responsiveness in patients with hip osteoarthritis (OA). Oxford hip score was translated and culturally adapted according to the guidelines in the literature. Seventy patients (mean age 61.45 ± 9.29 years) with hip osteoarthritis participated in the study. Patients completed the Turkish Oxford hip score (OHS-TR), the Short-Form 36 (SF-36), and Western Ontario and McMaster Universities Index (WOMAC). Internal consistency was tested using Cronbach's α coefficient. Patients completed OHS-TR questionnaire twice in 7 days for determining the reproducibility. Correlation between the total results of both tests was determined by the Pearson correlation coefficient and intraclass correlation coefficient (ICC). Validity was assessed by calculating the Pearson correlation coefficient between the OHS-TR and WOMAC and SF-36 scores. Floor and ceiling effects were analyzed. The internal consistency was high (Cronbach's α 0.93). The construct validity showed a significant correlation between the OHS-TR and WOMAC and related SF-36 domains (p < 0.001). The ICC's ranged between 0.80 and 0.99. There was no floor or ceiling effect in total OHS-TR score. The OHS-TR questionnaire is valid, reliable, and responsive for the Turkish-speaking patients with hip OA.

  7. The Dose-Related Effects of Extracorporeal Shock Wave Therapy for Knee Osteoarthritis

    PubMed Central

    Kim, Jin-Hong; Kim, Ja-Young; Choi, Cheol-Min; Lee, June-Kyung; Kee, Hoi-Sung; Jung, Kwang-Ik

    2015-01-01

    Objective To investigate the dose-related effects of extracorporeal shock wave therapy (ESWT) for knee osteoarthritis. Methods Seventy-five subjects were recruited, 60 of which met the inclusion criteria. The patients were randomly classified into two groups: group L, which was a low-energy group (n=30; 1,000 shocks/session; energy flux density [EFD], 0.040 mJ/mm2) and group M, which was a medium-energy group (n=30; 1,000 shocks/session; EFD, 0.093 mJ/mm2). For each group, 1,000 shock waves were delivered to the medial tibial plateau area, once a week, for 3 weeks. The main outcome measures were the visual analogue scale (VAS), the Roles and Maudsley (RM) score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and the Lequesne index. Each assessment was performed at the baseline and at 1, 4, and 12 weeks after ESWT. Results In both groups, the VAS, the RM and WOMAC scores, and the Lequesne index were significantly improved over time (p<0.001), and group M showed greater improvement over group L at the 1, 4 and 12 weeks assessments. Conclusion In this study, medium-energy group (group M) showed greater improvement in regard to relieving pain and restoring functional outcome than the low-energy group (group L). Therefore, EFD can be considered to have significant influence when treating with ESWT for knee osteoarthritis. PMID:26361599

  8. Navigated versus conventional total knee arthroplasty: A prospective study at three years follow-up.

    PubMed

    Martín-Hernández, C; Sanz-Sainz, M; Revenga-Giertych, C; Hernández-Vaquero, D; Fernández-Carreira, J M; Albareda-Albareda, J; Castillo-Palacios, A; Ranera-Garcia, M

    2018-03-28

    Computer-assisted surgery application in total knee arthroplasty (TKA) has shown more accurate implant alignment compared with conventional instrumentation and is associated with more homogeneous alignment results. Although longer implant survival and superior clinical outcomes should be expected from navigated TKA, currently available evidence does not support this hypothesis. The aim of this study was to compare navigated TKA with conventional TKA regarding clinical and radiological outcomes after a 3-year follow-up under the hypothesis that navigated TKA would provide better outcomes than conventional TKA. In a prospective multicentre study, 119 patients underwent navigated TKA and 80 patients received conventional instrumentation. Patients were evaluated at the baseline and at postoperative months 3, 12, 24, and 36. Analysis included the American Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form-12 (SF12) Health Survey, and radiographic assessment. All clinical scores improved significantly for all patients during the follow-up but were significantly better in the navigation group. The percentage of patients showing a mechanical axis between 3° of varus and 3° of valgus was significantly higher in the ATR group (93%) than in the conventional TKA group (71%) (P<.01). The use of computer-assisted surgery in TKA provides more accurate mechanical alignment and superior short-term functional outcomes compared to conventional TKA. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Effect of virgin olive oil versus piroxicam phonophoresis on exercise-induced anterior knee pain.

    PubMed

    Nakhostin-Roohi, Babak; Khoshkhahesh, Faegheh; Bohlooli, Shahab

    2016-01-01

    The main purpose of this study was to evaluate the effects of virgin olive oil phonophoresis on female athletes' anterior knee pain (AKP). A double blinded randomized clinical trial was conducted. Ninety-three female athletes suffering from AKP voluntarily participated in this study. Patients were randomly assigned into olive oil (n=31), piroxicam (n=31) or base gel phonophoresis (n=31) groups. At the baseline visit, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire was filled by subjects who were then treated with olive oil, piroxicam or pure phonophoresis for 12 sessions. After 6 and 12 sessions of physiotherapy, subjects filled the questionnaire again. Main outcomes were significant improvement in pain, stiffness, physical function, and total WOMAC scores. Although, there was a significant reduction in symptoms of AKP at the end of the therapy in all groups (p<0.05), but in olive oil group, this improvement was seen after 6 sessions of treatment (p<0.001). A significant difference between olive oil group and piroxicam and/or phonophoresis group was observed after 6 sessions of therapy (p<0.05). It could be proposed that phonophoresis with virgin olive oil is as effective as piroxicam gel on lowering WOMAC scores of AKP in female athletes and also has several beneficial properties including faster effect and shorter duration of therapy. The exact mechanism of beneficial action of virgin olive oil on AKP is not clear and requires further studies.

  10. Kinesiotape and quadriceps strengthening with elastic band in women with knee osteoarthritis and overweight or obesity. A randomized clinical trial.

    PubMed

    León-Ballesteros, Saúl; Espinosa-Morales, Rolando; Clark-Peralta, Patricia; Gómez-Pineda, Ascención Guadalupe; Guadarrama-Becerril, Jaime Horacio

    2018-04-07

    The beneficial effects of exercise in the treatment of Osteoarthritis (OA) of the knee have been verified in several studies. Kinesiotaping (KT) has been popularized due to its reducing local pressure and increasing circulation, resulting in decreased pain. Determine the clinical effectiveness of strengthening therapy with KT in women with knee OA for pain reduction. Thirty two women with knee OA, aged 50-70 years, with overweight or obesity grade I, who were randomized into two groups: one with exercise and KT, and the other, with exercise and placebo technique. Both groups performed stretching and quadriceps strengthening exercise with the elastic band 3 days weekly for 6 weeks. Measurement of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale was taken as primary outcome. Stiffness and functionality of the same index and the Visual Analog Scale (VAS) for pain intensity were measured. At the end of the study, there were no significant differences between the groups. Both groups had a difference of 2.7 points with respect to the baseline measurement, change percentage of 32.2% and 31.1% for placebo and experimental respectively (p=0.2). KT plus quadriceps strengthening exercise does not offer advantages for improvement of pain compared with quadriceps strengthening exercise alone in knee OA. Copyright © 2018 Sociedad Espaola de Reumatologa y Colegio Mexicano de Reumatologa. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Effectiveness of balance exercises in the acute post-operative phase following total hip and knee arthroplasty: A randomized clinical trial

    PubMed Central

    Overend, Tom J; Spaulding, Sandi J; Zecevic, Aleksandra; Kramer, John F

    2015-01-01

    Objectives: To determine the effectiveness of balance exercises in the acute post-operative phase following total hip arthroplasty or total knee arthroplasty. Methods: Patients who had total hip arthroplasty (n = 30) or total knee arthroplasty (n = 33) were seen in their residence 1–2 times per week for 5 weeks. At the first post-operative home visit, patients were randomly assigned to either typical (TE, n = 33) or typical plus balance (TE + B, n = 30) exercise groups. The TE group completed seven typical surgery-specific joint range-of-motion and muscle strengthening exercises, while the TE + B group completed the typical exercises plus three balance exercises. Patients were assessed before and 5 weeks after administering the rehabilitation program using four outcome measures: (1) the Berg Balance Scale, (2) the Timed Up and Go test, (3) the Western Ontario McMaster Universities Osteoarthritis Index, and (4) the Activities-specific Balance Confidence Scale. Results: Post-intervention scores for all four outcome measures were significantly improved (p < 0.01) over baseline scores. Patients who participated in the TE + B group demonstrated significantly greater improvement on the Berg Balance Scale and the Timed Up and Go tests (p < 0.01). Conclusion: Balance exercises added to a typical rehabilitation program resulted in significantly greater improvements in balance and functional mobility compared to typical exercises alone. PMID:26770765

  12. [Effect of posterior cruciate ligament retaining or not on knee-joint proprioception].

    PubMed

    Wu, Yansheng; Li, Yongsheng; Chen, Baicheng

    2013-07-01

    To analyze the effect of the posterior cruciate ligament (PCL) retaining or not on knee-joint proprioception by comparing the proprioceptive difference between PCL retaining and no PCL retaining in total knee arthroplasty (TKA). Between June 2009 and June 2010, 38 osteoarthritis patients meeting the inclusion criteria were divided into PCL retaining group (group A, n=19) and PCL-substituting group (group B, n=19) according to the random number table. There was no significant difference in gender, age, disease duration, the range of motion of the knee between 2 groups (P > 0.05). The effectiveness and the knee-joint proprioception were separately assessed by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score and the passive angle reproduction test (30, 60, and 90 degrees of knee flexion) preoperatively and 12 months postoperatively. All incisons healed by first intention, without complications of infection, fracture, and deep vein thrombosis of lower limb. The patients were followed up 12-17 months (mean, 14.1 months). The knee function after operation was obviously improved when compared with preoperative one; significant differences were observed in the WOMAC scores and the results of passive angle reproduction test between at preoperation and at 12 months after operation (P < 0.05), but no significant difference was found between group A and group B (P > 0.05). Whether PCL retaining or not in TKA both can improve knee-joint proprioception, and no obvious difference between them.

  13. A prospective before-and-after trial of an educational intervention about pharmaceutical marketing.

    PubMed

    Agrawal, Sacha; Saluja, Inderpal; Kaczorowski, Janusz

    2004-11-01

    There is increasing evidence that physicians may be compromised by their interactions with the pharmaceutical industry. The authors aimed to develop and determine the effect of an educational intervention to inform family medicine residents about pharmaceutical marketing. Confidential, self-administered questionnaires were administered to family medicine residents at McMaster University, Hamilton, Canada, immediately before and after a two-part, 2.5-hour educational intervention. The curriculum consisted of (1) a faculty-led debate and discussion of a systematic review of physician-pharmaceutical industry interactions, and (2) an interactive workshop that included a presentation highlighting key empirical findings, a video illustrating techniques to optimize pharmaceutical sales representatives' visits, and small- and large-group problem-based discussions. Residents were asked about their attitudes toward five marketing strategies: drug samples, industry-sponsored continuing medical education, one-on-one interactions with sales representatives, free meals, and gifts worth less than CAN $10. A total of 37 residents responded to both questionnaires. After the intervention residents had more cautious attitudes, rating marketing strategies on a five-point Likert scale as less ethically appropriate (-0.41, p < .05) and less valuable to patients or useful to the resident (-0.39, p < .05), and reporting less intention to use them in the future (-0.44, p < .01). This intervention appears to have promoted more cautious attitudes toward pharmaceuticals marketing. Its long-term sustainability and effect on behavior remain unknown.

  14. The impact of an arts-based programme on the affective and cognitive components of empathic development.

    PubMed

    Zazulak, Joyce; Halgren, Camilla; Tan, Megan; Grierson, Lawrence E M

    2015-06-01

    Medical education research demonstrates that empathic behaviour is amenable to positive change when targeted through educational programmes. This study evaluates the impact of an arts-based intervention designed to nurture learner empathy through the provision of facilitated visual literacy activities. Health Sciences students (N=19) were assigned to two learning groups: a group that participated in a visual literacy programme at the McMaster Museum of Art and a control group that participated in the normal Health Sciences curriculum. All participants completed an inter-reactivity index, which measures empathy on affective and cognitive levels, prior to and following the programme. Those individuals assigned to the visual literacy programme also completed open-ended questions concerning the programme's impact on their empathic development. The index scores were subjected to independent within-group, between-test analyses. There was no significant impact of the programme on the participants' overall empathic response. However, sub-component analyses revealed that the programme had a significant positive effect on cognitive aspects of empathy. This finding was substantiated by the narrative reports. The study concludes that the affective focus of humanities-based education needs to be enhanced and recommends that learners are educated on the different components that comprise the overall empathic response. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. The effect of vitamin D supplementation on knee osteoarthritis: A meta-analysis of randomized controlled trials.

    PubMed

    Gao, Xu-Ren; Chen, Ye-Shuai; Deng, Wei

    2017-10-01

    We conducted a meta-analysis of RCTs to evaluate the effects of vitamin D supplementation in the prevention of symptom and structural progression of knee OA. PubMed, Embase, and Web of Science databases were searched to identify relevant studies. Outcomes included Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, function, stiffness, tibial cartilage volume, and serum vitamin D3 levels, and adverse events. Results were expressed as weight mean difference (WMD) with 95% confidence interval (CI), and risk ratio (RR) with 95%CI. Four RCTs involving 1136 patients were included in this study. Pooled estimates suggested that vitamin D supplementation was associated with a significant reduction in WOMAC pain, and WOMAC function, but not in WOMAC stiffness. Vitamin D supplementation increased the serum vitamin D3 level, but had no effect on tibial cartilage volume. Subgroup analysis showed that, a daily supplement of more than 2000 IU vitamin D significantly decreased the WOMAC pain and WOMAC function. There was no significant difference in incidence of adverse events between the vitamin D and placebo groups. Vitamin D supplementation was effective in improving the WOMAC pain and function in patients with knee OA. However, it had no beneficial effect on the prevention of tibial cartilage loss. Therefore, there is currently a lack of evidence to support the use of vitamin D supplementation in preventing the progression of knee OA. Copyright © 2017. Published by Elsevier Ltd.

  16. A study of library use in problem-based and traditional medical curricula.

    PubMed

    Marshall, J G; Fitzgerald, D; Busby, L; Heaton, G

    1993-07-01

    A key question for librarians and medical educators who are planning for curriculum change is whether students and faculty in problem-based learning (PBL) programs use the library and its resources differently than do participants in traditional programs. During 1991, this research question was explored at three medical schools in the province of Ontario, Canada. At the time of the study, McMaster University medical school was totally problem-based, the University of Western Ontario had one PBL day each week for first-year medical students, and the University of Toronto, although planning for medical curriculum change, had not yet initiated PBL. Data collected in the study suggest that more medical students in the problem-based curriculum than in the more traditional programs use the library and that, when the PBL students use the library, they do so more frequently, for longer periods of time, and as a source of a greater proportion of their study materials. PBL students also use the library more than their counterparts as a place to study and meet other students. Students in the problem-based curriculum use the following resources more extensively: end-user MEDLINE searching, library journals, reserve or short-term loan materials, photocopy services, and audiovisual materials. PBL students also report purchasing more textbooks. In contrast to the differences found among medical students, however, patterns of library and resource use by medical faculty at the three schools were quite similar.

  17. Baylisascaris schroederi Infection in Giant Pandas (Ailuropoda melanoleuca) in Foping National Nature Reserve, China.

    PubMed

    Peng, Zhiwei; Zhang, Changsheng; Shen, Meiying; Bao, Heng; Hou, Zhijun; He, Shaowen; Hua, Yuping

    2017-10-01

    The giant panda (Ailuropoda melanoleuca) is the most iconic endangered species in the world, but there is little information about the spatial and temporal distribution of parasites in the wild giant panda population. In total, 193 fecal samples from giant pandas in the Foping National Nature Reserve, People's Republic of China, were analyzed for parasite eggs using a modification of the McMaster technique. The morphology and size of Baylisascaris schroederi eggs were observed under an optical microscope. The prevalence and intensity of B. schroederi infection during the sampling year 2012 were 52.3% (101/193) and 89 eggs/g of feces, respectively, among giant pandas in this population. The prevalence of B. schroederi in the pandas varied during different months of the year, from 7% to 100%, and the prevalences in spring, summer, autumn, and winter were 71, 77, 23, and 18%, respectively. The prevalence was not significantly different between giant pandas that ate two different types of bamboo, but the intensity of infection was higher in the group eating Arundinaria fargesii (P=0.043). Altitude, temperature, and dew point were correlated with the infection intensity (r=-0.224, P<0.001; r=0.328, P<0.001; r=0.328, P=0.028, respectively). There was no correlation between infection intensity and distance to rivers. This study provides a better understanding of B. schroederi prevalence among the wild giant pandas in Foping National Nature, China.

  18. Turn on the lights: leveraging visible light for communications and positioning

    NASA Astrophysics Data System (ADS)

    Hranilovic, Steve

    2015-01-01

    The need for ubiquitous broadband connectivity is continually growing, however, radio spectrum is increasingly scarce and limited by interference. In addition, the energy efficiency of many radio transmitters is low and most input energy is converted to heat. A widely overlooked resource for positioning and broadband access is optical wireless communication reusing existing illumination installations. As many of the 14 billion incandescent bulbs in use worldwide are converted to energy efficient LED lighting, a unique opportunity exists to augment them with visible light communications (VLC) and visible light positioning (VLP). VLC- and VLP- enabled LED lighting is not only energy efficient but enables a host of new use cases such as location-aware ubiquitous high-speed wireless communication links. This talk presents the recent work of the Free-space Optical Communication Algorithms Laboratory (FOCAL) at McMaster University in Hamilton, Canada in developing novel signaling and indoor localization techniques using illumination devices. Developments in the signaling design for VLC systems will be presented along with several prototype VLC communication systems. Novel approaches to the integration of VLC networks with power line communications (PLC) are discussed. The role of visible light communications and ranging for automotive safety will also be highlighted. Several approaches to indoor positioning using illumination devices and simple smartphone-based receivers will be presented. Finally, a vision for VLC and VLP technologies will be presented along with our ongoing research directions.

  19. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing: a concise follow-up at a mean of 3.7 years.

    PubMed

    van Jonbergen, H P W; Scholtes, V A B; Poolman, R W

    2014-04-01

    In the absence of patellar resurfacing, we have previously shown that the use of electrocautery around the margin of the patella improved the one-year clinical outcome of total knee replacement (TKR). In this prospective randomised study we compared the mean 3.7 year (1.1 to 4.2) clinical outcomes of 300 TKRs performed with and without electrocautery of the patellar rim: this is an update of a previous report. The overall prevalence of anterior knee pain was 32% (95% confidence intervals [CI] 26 to 39), and 26% (95% CI 18 to 35) in the intervention group compared with 38% (95% CI 29 to 48) in the control group (chi-squared test; p = 0.06). The overall prevalence of anterior knee pain remained unchanged between the one-year and 3.7 year follow-up (chi-squared test; p = 0.12). The mean total Western Ontario McMasters Universities Osteoarthritis Indices and the American Knee Society knee and function scores at 3.7 years' follow-up were similar in the intervention and control groups (repeated measures analysis of variance p = 0.43, p = 0.09 and p = 0.59, respectively). There were no complications. A total of ten patients (intervention group three, control group seven) required secondary patellar resurfacing after the first year. Our study suggests that the improved clinical outcome with electrocautery denervation compared with no electrocautery is not maintained at a mean of 3.7 years' follow-up.

  20. Quality in physical therapist clinical education: a systematic review.

    PubMed

    McCallum, Christine A; Mosher, Peter D; Jacobson, Peri J; Gallivan, Sean P; Giuffre, Suzanne M

    2013-10-01

    Many factors affect student learning throughout the clinical education (CE) component of professional (entry-level) physical therapist education curricula. Physical therapist education programs (PTEPs) manage CE, yet the material and human resources required to provide CE are generally overseen by community-based physical therapist practices. The purposes of this systematic review were: (1) to examine how the construct of quality is defined in CE literature and (2) to determine the methodological rigor of the available evidence on quality in physical therapist CE. This study was a systematic review of English-language journals using the American Physical Therapy Association's Open Door Portal to Evidence-Based Practice as the computer search engine. The search was categorized using terms for physical therapy and quality and for CE pedagogy and models or roles. Summary findings were characterized by 5 primary themes and 14 subthemes using a qualitative-directed content analysis. Fifty-four articles were included in the study. The primary quality themes were: CE framework, CE sites, structure of CE, assessment in CE, and CE faculty. The methodological rigor of the studies was critically appraised using a binary system based on the McMaster appraisal tools. Scores ranged from 3 to 14. Publication bias and outcome reporting bias may be inherent limitations to the results. The review found inconclusive evidence about what constitutes quality or best practice for physical therapist CE. Five key constructs of CE were identified that, when aggregated, could construe quality.

  1. Mediated moderation of the relation between maternal and adolescent depressive symptoms: role of adolescent physical health.

    PubMed

    Ferro, Mark A

    2015-11-01

    To examine the mediating effect of family functioning on the relation between maternal and adolescent depressive symptoms and determine whether the magnitude of the mediating effect is different for adolescents with and without chronic physical health conditions. Data come from the National Longitudinal Survey of Children and Youth. A representative survey of 11,813 adolescents and their mothers was included. Maternal and adolescent depressive symptoms were measured using the 12-item Center for Epidemiological Studies Depression Scale. Family functioning was measured using the McMaster Family Assessment Device. Multilevel multiple-group path analysis was used to examine potential mediating and moderating effects. Family functioning measured when adolescents were 14-15 years mediated the relation between maternal depressive symptoms (measured at 10-13 years) and adolescent depressive symptoms (measured at 16-19 years) for both adolescents with [αβ = 0.02 (0.02, 0.03)] and without chronic health conditions [αβ = 0.01 (0.00, 0.01)]. These findings provided evidence to suggest mediated moderation, Δαβ = 0.02 (0.01, 0.03), that is, the mediating effect of family functioning was significantly larger for adolescents with chronic health conditions. The mediating effect of family functioning in the relation between maternal and adolescent depressive symptoms is larger for adolescents with chronic health conditions. Within the framework of family-centered care, maternal depressive symptoms and family functioning are suitable targets for preventive intervention for adolescents with chronic health conditions.

  2. Deep-Water Coral Diversity and Habitat Associations: Differences among Northeast Atlantic Submarine Canyons

    NASA Astrophysics Data System (ADS)

    Shank, T. M.

    2016-02-01

    From 2012 to 2015, annual seafloor surveys using the towed camera TowCam were used to characterize benthic ecosystems and habitats to groundtruth recently developed habitat suitability models that predict deep-sea coral locations in northwest Atlantic canyons. Faunal distribution, abundance, and habitat data were obtained from more than 90 towed camera surveys in 21 canyons, specifically Tom's, Hendrickson, Veatch, Gilbert, Ryan, Powell, Munson, Accomac, Leonard, Washington, Wilmington, Lindenkohl, Clipper, Sharpshooter, Welker, Dogbody, Chebacco, Heel Tapper, File Bottom, Carteret, and Spencer Canyons, as well as unnamed minor canyons and inter-canyon areas. We also investigated additional canyons including Block, Alvin, Atlantis, Welker, Heezen, Phoenix, McMaster, Nantucket, and two minor canyons and two intercanyon areas through high-definition ROV image surveys from the NOAA CANEX 2013 and 2014 expeditions. Significant differences in species composition and distribution correlated with specific habitat types, depth, and individual canyons. High abundances and diversity of scleractinians, antipatharians, octocorals and sponges were highly correlated with habitat substrates, includingvertical canyon walls, margins, sediments, cobbles, boulders, and coral rubble habitat. Significant differences in species composition among canyons were observed across similar depths suggesting that many canyons may have their own biological and geological signature. Locating and defining the composition and distribution of vulnerable coral ecosystems in canyons in concert with validating predictive species distribution modeling has resulted in the regional management and conservation recommendations of these living resources and the largest proposed Marine Protected Area in North American waters.

  3. Development of a multi-element microdosimetric detector based on a thick gas electron multiplier

    NASA Astrophysics Data System (ADS)

    Anjomani, Z.; Hanu, A. R.; Prestwich, W. V.; Byun, S. H.

    2017-03-01

    A prototype multi-element gaseous microdosimetric detector was developed using the Thick Gas Electron Multiplier (THGEM) technique. The detector aims at measuring neutron and gamma-ray dose rates for weak neutron-gamma radiation fields. The multi-element design was employed to increase the neutron detection efficiency. The prototype THGEM multi-element detector consists of three layers of tissue equivalent plastic hexagons and each layer houses a hexagonal array of seven cylindrical gas cavity elements with equal heights and diameters of 17 mm. The final detector structure incorporates 21 gaseous volumes. Owing to the absence of wire electrodes, the THGEM multi-element detector offers flexible and convenient fabrication. The detector responses to neutron and gamma-ray were investigated using the McMaster Tandetron 7Li(p,n) neutron source. The dosimetric performance of the detector is presented in contrast to the response of a commercial tissue equivalent proportional counter. Compared to the standard TEPC response, the detector gave a consistent microdosimetric response with an average discrepancy of 8 % in measured neutron absorbed dose. An improvement of a factor of 3.0 in neutron detection efficiency has been accomplished with only a small degradation in energy resolution. However, its low energy cut off is about 6 keV/μm, which is not sufficient to measure the gamma-ray dose. This problem will be addressed by increasing the electron multiplication gain using double THGEM layers.

  4. A prospective evaluation of the ligation of the intersphincteric tract procedure for complex anal fistula in patients with Crohn's disease.

    PubMed

    Gingold, Daniel S; Murrell, Zuri A; Fleshner, Phillip R

    2014-12-01

    To evaluate 2- and 12-month outcomes after ligation of the intersphincteric fistula tract (LIFT) in Crohn's disease (CD). Surgical approaches to perianal fistulas in CD are frequently ineffective and hampered by concerns over adequate wound healing and sphincter injury. The efficacy of LIFT in CD patients is unknown. Consecutive cases of CD patients with transsphincteric fistulas were prospectively analyzed. Fistula healing and 2 validated quality-of-life indices were assessed. Fifteen CD patients (9 women; mean age = 34.8 years) were identified. Location of the fistula was lateral (n = 10; 67%) or midline (n = 5; 33%). LIFT site healing was seen in 9 patients (60%) at 2-month follow-up. No patient developed fecal incontinence. LIFT site healing was seen in 8 of the 12 patients (67%) with complete 12-month follow-up. Significant factors for long-term LIFT site healing were lateral versus midline location (P = 0.02) and longer mean fistula length (P = 0.02). Patients who had successful operations significantly improved both their mean Wexner Perianal Crohn's Disease Activity Index and McMaster Perianal Crohn's Disease Activity Index quality-of-life scores at 2-month follow-up (14.0-3.8, P = 0.001, and 10.4-1.8, P = 0.0001, respectively). CD-associated anal fistulas may be treated with LIFT. This surgical procedure is a safe, outpatient procedure that minimizes both perianal wound creation and sphincter injury.

  5. Problem-based learning in undergraduate medical education: can we really implement it in the West African subregion?

    PubMed

    Gukas, I D

    2007-01-01

    A major global pedagogical shift has occurred in the way medicine is taught over the last half a century. Problem-based learning (PBL) has emerged as one of the most popular, of these learner-centred new methods. To examine the evolution and educational principles of PBL and the feasibility of implementing it in the West African subregion. Key literature detailing the history, educational value and principle behind PBL were reviewed. Issues regarding the implication of implementing PBL to West Africa were deduced and suggestions made for the way forward. Since its introduction in McMaster University in Canada in the 60s, PBL has spread all over world. It is rooted in sound educational theories like the Kolb's experiential learning, adult education, collaborative learning, contextual learning and constructivism. Compared to traditionally trained students, PBL students find learning more enjoyable and develop better relational and professional skills. They show more causal reasoning in diagnosis and become better lifelong learners. Issues that may affect its implementation in West Africa include high start up costs, lack of supporting educational technology and relative lack of medical school managers with appropriate medical education background to assess and evaluate such innovations. The evidence for the need for a change from the traditional method of training is overwhelming. Implementation of PBL as an educational method in medical training in the West African subregion is both desirable and practicable if we address some of the issues outlined above.

  6. Knee osteoarthritis, degenerative meniscal lesion and osteonecrosis of the knee: Can a simple gait test direct us to a better clinical diagnosis.

    PubMed

    Debi, R; Elbaz, A; Mor, A; Kahn, G; Peskin, B; Beer, Y; Agar, G; Morag, G; Segal, G

    2017-06-01

    The purpose of the current study was to compare the gait patterns in patients with three differing knee pathologies - knee osteoarthritis (OA), degenerative meniscal lesion (DML) and spontaneous osteonecrosis of the knee (SONK) and a group of healthy controls. A simple gait test will detect differences between different knee pathologies. Forty-seven patients with bilateral knee OA, 47 patients with DML, 28 patients with SONK and 27 healthy controls were included in this analysis. Patients underwent a spatiotemporal gait assessment and were asked to complete the Western Ontario and McMaster University (WOMAC) Index and the Short-Form (SF)-36 Health Survey. ANOVA tests, followed by Bonferroni multiple comparison tests and the Chi 2 tests were performed for continuous and categorical variables, respectively. Significant differences were found for all gait measures and clinical questionnaires between healthy controls and all knee conditions. Patients with SONK differed from patients with bilateral knee OA and DML in all gait measures and clinical questionnaires, except for WOMAC subscales. There were no significant differences between patients with bilateral knee OA and patients with DML. Symmetry was also examined and revealed asymmetry in some gait parameters in patients with SONK and DML. Based on the differences in gait parameters that were found in the current study, adding an objective functional spatiotemporal gait test may assist in the diagnostic process of knee pathologies. Case Control study Level III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  7. Effects of a 10-week toe-out gait modification intervention in people with medial knee osteoarthritis: a pilot, feasibility study.

    PubMed

    Hunt, M A; Takacs, J

    2014-07-01

    To examine the feasibility of a 10-week gait modification program in people with medial tibiofemoral knee osteoarthritis (OA), and to assess changes in clinical and biomechanical outcomes. Fifteen people with medial knee OA completed 10 weeks of gait modification focusing on increasing toe-out angle during stance 10° compared to their self-selected angle measured at baseline. In addition to adherence and performance difficulty outcomes, knee joint symptoms (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and total score, numerical rating scale (NRS) of pain), and knee joint loading during gait (late stance peak knee adduction moment (KAM)) were assessed. Participants were able to perform the toe-out gait modification program with minimal to moderate difficulty, and exhibited significant increases in self-selected toe-out angle during walking (P < 0.001). Joint discomfort was reported by five participants (33%) in the hip or knee joints, though none lasted longer than 2 weeks. Participants reported statistically significant reductions in WOMAC pain (P = 0.02), NRS pain (P < 0.001), WOMAC total score (P = 0.02), and late stance KAM (P = 0.04). These preliminary findings suggest that toe-out gait modification is feasible in people with medial compartment knee OA. Preliminary changes in clinical and biomechanical outcomes provide the impetus for conducting larger scale studies of gait modification in people with knee OA to confirm these findings. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  8. Do Psychosocial Factors Predict Muscle Strength, Pain, or Physical Performance in Patients With Knee Osteoarthritis?

    PubMed

    Baert, Isabel A C; Meeus, Mira; Mahmoudian, Armaghan; Luyten, Frank P; Nijs, Jo; Verschueren, Sabine M P

    2017-09-01

    The aim of this study was to examine the relationship of psychosocial factors, namely, pain catastrophizing, kinesiophobia, and maladaptive coping strategies, with muscle strength, pain, and physical performance in patients with knee osteoarthritis (OA)-related symptoms. A total of 109 women (64 with knee OA-related symptoms) with a mean age of 65.4 years (49-81 years) were recruited for this study. Psychosocial factors were quantified by the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Pain Coping Inventory. Clinical features were assessed using isometric and isokinetic knee muscle strength measurements, visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, and functional tests. Associations were examined using correlation and regression analysis. In knee OA patients, pain catastrophizing, kinesiophobia, and coping strategy explained a significant proportion of the variability in isometric knee extension and flexion strength (6.3%-9.2%), accounting for more overall variability than some demographic and medical status variables combined. Psychosocial factors were not significant independent predictors of isokinetic strength, knee pain, or physical performance. In understanding clinical features related to knee OA, such as muscle weakness, pain catastrophizing, kinesiophobia, and coping strategy might offer something additional beyond what might be explained by traditional factors, underscoring the importance of a biopsychosocial approach in knee OA management. Further research on individual patient characteristics that mediate the effects of psychosocial factors is, however, required in order to create opportunities for more targeted, personalized treatment for knee OA.

  9. Mechanical factors relate to pain in knee osteoarthritis.

    PubMed

    Maly, Monica R; Costigan, Patrick A; Olney, Sandra J

    2008-07-01

    Pain experienced by people with knee osteoarthritis is related to psychosocial factors and damage to articular tissues and/or the pain pathway itself. Mechanical factors have been speculated to trigger this pain experience; yet mechanics have not been identified as a source of pain in this population. The purpose of this study was to identify whether mechanics could explain variance in pain intensity in people with knee osteoarthritis. Data from 53 participants with physician-diagnosed knee osteoarthritis (mean age=68.5 years; standard deviation=8.6 years) were analyzed. Pain intensity was reported on the Western Ontario and McMaster Universities Osteoarthritis Index. Mechanical measures included weight-bearing varus-valgus alignment, body mass index and isokinetic quadriceps torque. Gait analysis captured the range of adduction-abduction angle, range of flexion-extension angle and external knee adduction moment during level walking. Pain intensity was significantly related to the dynamic range of flexion-extension during gait and body mass index. A total of 29% of the variance in pain intensity was explained by mechanical variables. The range of flexion-extension explained 18% of variance in pain intensity. Body mass index added 11% to the model. The knee adduction moment was unrelated to pain intensity. The findings support that mechanical factors are related to knee osteoarthritis pain. Because limitations in flexion-extension range of motion and body size are modifiable factors, future research could examine whether interventions targeting these mechanics would facilitate pain management.

  10. Effectiveness of aquatic exercises compared to patient-education on health status in individuals with knee osteoarthritis: a randomized controlled trial.

    PubMed

    Taglietti, Marcelo; Facci, Ligia Maria; Trelha, Celita Salmaso; de Melo, Fernanda Cristiane; da Silva, Daniela Wosiack; Sawczuk, Geovane; Ruivo, Thamires Marques; de Souza, Thaisley Barbosa; Sforza, Chiarella; Cardoso, Jefferson Rosa

    2018-06-01

    To compare the effectiveness of aquatic exercises with patient-education in individuals with knee osteoarthritis. Randomized controlled trial with blinded assessor and intention-to-treat analysis. Aquatic Physiotherapy Centre and Primary Health Care Unit. A total of 60 patients, aged 68.3 (SD = 4.8) with clinical symptoms and radiographic grading (Kellgren-Lawrence 1-4) of knee osteoarthritis were included. An eight-week treatment protocol of aquatic exercise ( n = 31) (16 individual sessions, twice a week) and an educational program (group sessions, once a week) ( n = 29). Before, after eight-week intervention, and a three-month follow-up with results for the following outcome measures: pain, function, quality of life, functional mobility, and depression. At the end of treatment, the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) functional capacity values reduced in favour of the aquatic exercise group for both the total score MD (mean difference) = -14.2; 95% CI (confidence interval) (-18; -10.5), P = 0.04 and the pain domain MD = -3.8 points; 95% CI (-8.71; -1), P = 0.021. The total score also reduced in the follow-up: MD = -12.3 points; 95% CI (-24.7; -6.1), P = 0.017. No differences were found for the outcomes functional mobility or depression. Aquatic exercise improved pain and function after eight weeks, and function at the three-month follow-up compared to the patient-education program.

  11. Patellofemoral pain and asymmetrical hip rotation.

    PubMed

    Cibulka, Michael T; Threlkeld-Watkins, Julie

    2005-11-01

    Patellofemoral joint problems are the most common overuse injury of the lower extremity, and altered femoral or hip rotation may play a role in patellofemoral pain. The purpose of this case report is to describe the evaluation of and intervention for a patient with asymmetrical hip rotation and patellofemoral pain. The patient was a 15-year-old girl with an 8-month history of anterior right knee pain, without known trauma or injury. Prior to intervention, her score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was 24%. Right hip medial (internal) rotation was less than left hip medial rotation, and manual muscle testing showed weakness of the right hip internal rotator and abductor muscles. The intervention was aimed at increasing right hip medial rotation, improving right hip muscle strength (eg, the muscle force exerted by a muscle or a group of muscles to overcome a resistance), and eliminating anterior right knee pain. After 6 visits (14 days), passive left and right hip medial rotations were symmetrical, and her right hip internal rotator and abductor muscle grades were Good plus. Her WOMAC score was 0%. The patient had right patellofemoral pain and an uncommon pattern of asymmetrical hip rotation, with diminished hip medial rotation and excessive hip lateral (external) rotation on the right side. The patient's outcomes suggest that femoral or hip joint asymmetry may be related to patellofemoral joint pain.

  12. Differences in Clinical Pain and Experimental Pain Sensitivity Between Asian Americans and Whites With Knee Osteoarthritis.

    PubMed

    Ahn, Hyochol; Weaver, Michael; Lyon, Debra E; Kim, Junglyun; Choi, Eunyoung; Staud, Roland; Fillingim, Roger B

    2017-02-01

    Ethnicity has been associated with clinical and experimental pain responses. Whereas ethnic disparities in pain in other minority groups compared with whites are well described, pain in Asian Americans remains poorly understood. The purpose of this study was to characterize differences in clinical pain intensity and experimental pain sensitivity among older Asian American and non-Hispanic white (NHW) participants with knee osteoarthritis (OA). Data were collected from 50 Asian Americans ages 45 to 85 (28 Korean, 9 Chinese, 7 Japanese, 5 Filipino, and 1 Indian) and compared with 50 age-matched and sex-matched NHW individuals with symptomatic knee OA pain. The Western Ontario and McMaster Universities Osteoarthritis Index and Graded Chronic Pain Scale were used to assess the intensity of clinical knee pain. In addition, quantitative sensory testing was used to measure experimental sensitivity to heat-induced and mechanically induced pain. Asian American participants had significantly higher levels of clinical pain intensity than NHW participants with knee OA. In addition, Asian American participants had significantly higher experimental pain sensitivity than NHW participants with knee OA. These findings add to the growing literature regarding ethnic and racial differences in clinical pain intensity and experimental pain sensitivity. Asian Americans in particular may be at risk for clinical pain and heightened experimental pain sensitivity. Further investigation is needed to identify the mechanisms underlying ethnic group differences in pain between Asian Americans and NHWs, and to ensure that ethnic group disparities in pain are ameliorated.

  13. Posterolateral hip muscle strengthening versus quadriceps strengthening for patellofemoral pain: a comparative control trial.

    PubMed

    Khayambashi, Khalil; Fallah, Alireza; Movahedi, Ahmadreza; Bagwell, Jennifer; Powers, Christopher

    2014-05-01

    To compare the efficacy of posterolateral hip muscle strengthening versus quadriceps strengthening in reducing pain and improving health status in persons with patellofemoral pain (PFP). Comparative control trial. Rehabilitation facility. Persons with a diagnosis of PFP (N=36; 18 men, 18 women). Patients were alternately assigned to a posterolateral hip muscle strengthening group (9 men and 9 women) or a quadriceps strengthening group (9 men and 9 women). The posterolateral hip muscle strengthening group performed hip abductor and external rotator strengthening exercises, whereas the quadriceps strengthening group performed quadriceps strengthening exercises (3 times a week for 8wk). Pain (visual analog scale [VAS]) and health status (Western Ontario McMaster Universities Osteoarthritis Index [WOMAC]) were assessed at baseline, postintervention, and 6-month follow-up. Significant improvements in VAS and WOMAC scores were observed in both groups from baseline to postintervention and baseline to 6-month follow-up (P<.001). Improvements in VAS and WOMAC scores in the posterolateral hip exercise group were superior to those in the quadriceps exercise group postintervention and at 6-month follow-up (P<.05). Although both intervention programs resulted in decreased pain and improved function in persons with PFP, outcomes in the posterolateral hip exercise group were superior to the quadriceps exercise group. The superior outcomes obtained in the posterolateral hip exercise group were maintained 6 months postintervention. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Qualitative studies using in-depth interviews with older people from multiple language groups: methodological systematic review.

    PubMed

    Fryer, Caroline; Mackintosh, Shylie; Stanley, Mandy; Crichton, Jonathan

    2012-01-01

    This paper is a report of a methodological review of language appropriate practice in qualitative research, when language groups were not determined prior to participant recruitment. When older people from multiple language groups participate in research using in-depth interviews, additional challenges are posed for the trustworthiness of findings. This raises the question of how such challenges are addressed. The Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, Ageline, PsycINFO, Sociological abstracts, Google Scholar and Allied and Complementary Medicine databases were systematically searched for the period 1840 to September 2009. The combined search terms of 'ethnic', 'cultural', 'aged', 'health' and 'qualitative' were used. In this methodological review, studies were independently appraised by two authors using a quality appraisal tool developed for the review, based on a protocol from the McMaster University Occupational Therapy Evidence-Based Practice Research Group. Nine studies were included. Consideration of language diversity within research process was poor for all studies. The role of language assistants was largely absent from study methods. Only one study reported using participants' preferred languages for informed consent. More examples are needed of how to conduct rigorous in-depth interviews with older people from multiple language groups, when languages are not determined before recruitment. This will require both researchers and funding bodies to recognize the importance to contemporary healthcare of including linguistically diverse people in participant samples. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  15. Soil transmitted helminths and associated factors among schoolchildren in government and private primary school in Jimma Town, Southwest Ethiopia.

    PubMed

    Debalke, Serkadis; Worku, Amare; Jahur, Nejat; Mekonnen, Zeleke

    2013-11-01

    Soil transmitted helminth infections are among the most common human infections. They are distributed throughout the world with high prevalence rates in tropical and sub-tropical countries mainly because of lack of adequate sanitary facilities, inappropriate waste disposal systems, lack of safe water supply, and low socio-economic status. A comparative cross sectional study was conducted from December 2011 to June 2012 to determine and assess the prevalence of soil transmitted helminths and their associated factors among government and private primary school children. Stool samples were collected from 369 randomly selected children and examined microscopically for eggs of soil transmitted helminth following McMaster techniques. Soil samples were collected from different parts of the school compound and microscopic examination was performed for eggs of the helminths using sodium nitrate flotation technique. The overall prevalence rate of soil transmitted helminth infections in private and government schools was 20.9% and 53.5% respectively. T. trichiura was the most common soil transmitted helminth in both schools while hookworm infections were identified in government school students only. Type of school and sex were significantly associated with soil transmitted helminth. Soil contamination rate of the school compounds was 11.25% with predominant parasites of A. lumbricoides. Higher prevalence of soil transmitted helminth infection was found among government school students. Thus, more focus, on personal hygiene and sanitary facilities, should be given to children going to government schools.

  16. Ultrasound combined transcutaneous electrical nerve stimulation (UltraTENS) versus phonophoresis of piroxicam (PhP) in symptomatic knee osteoarthritis: A randomized double-blind, controlled trial.

    PubMed

    Boonhong, Jariya; Suntornpiyapan, Phitsanu; Piriyajarukul, Apatchanee

    2018-02-02

    Ultrasound combined with transcutaneous electrical nerve stimulation (UltraTENS) and phonophoresis of piroxicam (PhP) are combined modality therapy that frequently used in musculoskeletal pain including knee osteoarthritis (OA). But it is lack of a good clinical trial to prove and compare their effects. To compare the effects of UltraTENS with PhP on mild to moderate degree of symptomatic knee OA. Sixty-one patients (55 women), mean age of 63.4 ± 8.1 y, 50-90 mm VAS of knee pain and Kellgren-Lawrence score of grade I-III were randomly allocated into UltraTENS and PhP (N = 31 and 30, respectively). The UltraTENS group received a combined ultrasound with TENS program and a non-drug gel, whereas the PhP group got an ultrasound program with piroxicam gel and sham TENS. All patients were treated for a total of 10 sessions, consisting of five times per week and 10 min per session. Before and after treatment, patients were evaluated knee pain by using the 100-mm VAS and functional performance by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. The UltraTENS and PhP groups experienced considerable improvement in both VAS and total WOMAC scores post-treatment (P< 0.001). The PhP had better VAS of pain and WOMAC scores but no statistical significance. Results show that UltraTENS and PhP were effective for relieving pain and improve functionality knee OA without significant differences between their effects.

  17. WOMAC and SF-36: instruments for evaluating the health-related quality of life of elderly people with total hip arthroplasty. A descriptive study.

    PubMed

    Rampazo-Lacativa, Mariana Kátia; Santos, Ariene Angelini dos; Coimbra, Arlete Maria Valente; D'Elboux, Maria José

    2015-01-01

    Quality-of-life results have increasingly been evaluated among patients undergoing joint replacements. The objective of this study was to compare two assessment instruments for health-related quality of life (one generic and the other specific), among elderly patients undergoing total hip arthroplasty. Cross-sectional descriptive study in a reference hospital in the region of Campinas. The subjects were 88 elderly outpatients aged 60 years or over who underwent primary total hip arthroplasty. Two instruments for assessing health-related quality of life were applied: the generic Medical Study 36-item Short-Form Health Survey (SF-36) and the specific Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Cronbach's alpha and the ceiling and floor effects of the instruments were evaluated. The scores from both instruments showed that issues of a physical nature affected these elderly people's quality of life most. The pain and stiffness dimensions of WOMAC showed ceiling effects and only the functional capacity and pain dimensions of the SF-36 did not show the ceiling effect. The SF-36 presented floor effects in the dimensions of physical and emotional aspects. Cronbach's alpha was considered satisfactory in both instruments (α > 0.70). The floor and ceiling effects that were observed suggest that these instruments may present some limitations in detecting changes to the majority of the SF-36 dimensions, except for functional capacity and pain, and to the pain and stiffness dimensions of WOMAC, when applied to elderly people with total hip arthroplasty.

  18. Therapeutic efficacy of different brands of albendazole against soil transmitted helminths among students of Mendera Elementary School, Jimma, Southwest Ethiopia.

    PubMed

    Tefera, Ephrem; Belay, Tariku; Mekonnen, Seleshi Kebede; Zeynudin, Ahmed; Belachew, Tefera

    2015-01-01

    Different brands Albendazole are commercially available and the efficacious brand/s is/are required for effective control of STHs infection. Thus, this study is aimed at determining the therapeutic efficacy of different brands of albendazole against soil transmitted helminths among school children of Jimma town. A cross sectional survey for prevalence of geohelminths and a randomized trial for efficacy study of different brands of albendazole was conducted among students Mendera Elementary School from March 29 to April 29, 2010. Positive subjects were randomized into three treatment arms using lottery method. The collected stool samples were examined by the McMaster method. CRs were calculated using SPSS windows version 16 and ERRs were calculated using appropriate formula. Of the 715 school children who had their stools examined, 326 were positive for STHs with a prevalence rate of 45.6%. The cure rates (CR) for A. lumbricoides, T. trichiura and Hookworm were 99.4, 59.9 and 93.7%, respectively. Similarly, the egg reduction rates (ERR) were 97, 99.9 and 99.9% respectively. A statistical significant mean STH egg count difference were observed between pre and post-intervention study (p <0.001). But no statistical significant curing effect difference were observed among the three brands used against the three STHs (p >0.05). All the three brands of Albendazole tested regardless of the brand type were therapeutically efficacious for Ascariasis, Trichuriasis and Hookworm infections irrespective of the infection status whether it was single or multiple.

  19. Correlation of serum cartilage oligomeric matrix protein (COMP) and interleukin-16 (IL-16) levels with disease severity in primary knee osteoarthritis: A pilot study in a Malaysian population.

    PubMed

    Das Gupta, Esha; Ng, Wei Ren; Wong, Shew Fung; Bhurhanudeen, Abdul Kareem; Yeap, Swan Sim

    2017-01-01

    The aim of this study was to investigate the correlations between serum cartilage oligomeric matrix protein (COMP), interleukin-16 (IL-16) and different grades of knee osteoarthritis (KOA) in Malaysian subjects. Ninety subjects were recruited comprising 30 with Kellgren-Lawrence (K-L) grade 2 KOA, 27 with K-L grade 3 KOA, 7 with grade 4 KOA, and 30 healthy controls. All subjects completed the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Serum COMP and IL-16 levels were measured using ELISA and their values log transformed to ensure a normal distribution. There was no significant differences in levels of log serum COMP and IL-16 between healthy controls and KOA patients. There were no significant differences in the log serum COMP and IL-16 levels within the different K-L grades in the KOA patients. In KOA patients, log serum IL-16 levels significantly correlated with the WOMAC score (p = 0.001) and its subscales, pain (p = 0.005), stiffness (p = 0.019) and physical function (p<0.0001). Serum IL-16 levels were significantly higher in Malaysian Indians compared to Malays and Chinese (p = 0.024). In this multi-ethnic Malaysian population, there was no difference in serum COMP and IL-16 levels between healthy controls and patients with KOA, nor was there any difference in serum COMP or IL-16 levels across the various K-L grades of KOA. However, there were significant inter-racial differences in serum IL-16 levels.

  20. Prospective analyses of female urinary incontinence symptoms following total hip arthroplasty.

    PubMed

    Okumura, Keiko; Yamaguchi, Kumiko; Tamaki, Tatsuya; Oinuma, Kazuhiro; Tomoe, Hikaru; Akita, Keiichi

    2017-04-01

    Some patients with hip osteoarthritis report that urinary incontinence (UI) is improved following total hip arthroplasty (THA). However, the type and severity of UI remain unclear. In this study, we hypothesize that both stress urinary incontinence (SUI) and urge urinary incontinence (UUI) are improved after THA. We assess the characteristics of UI and discuss the anatomical factors related to UI and THA for improved treatment outcome. Fifty patients with UI who underwent direct anterior-approach THA were evaluated. Type of UI was assessed using four questionnaires: Core Lower Urinary Tract Symptom Score (CLSS), Urogenital Distress Inventory Short Form (UDI-6), International Prostate Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS). Uroflowmetry and postvoid residual urine were measured using ultrasound technology. Hip-joint function was evaluated using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and range of motion (ROM). Of the 50 patients, 21 had SUI, 16 had mixed urinary incontinence (MUI), and eight had urgency urinary incontinence (UUI). In total, 36 patients were better than improved (72 %). The rate of cured and improved was 76 % for SUI, 100 % MUI, and 50 % UUI. The improvement of ROM was more significant in cured or improved patients than in stable or worse patients. Improvement in mild UI may be an added benefit for those undergoing THA for hip-joint disorders. These data suggest that for patients with hip-joint disorder, hip-joint treatment could prove to also be a useful treatment for UI.

  1. The effect of balneotherapy on pain relief, stiffness, and physical function in patients with osteoarthritis of the knee: a meta-analysis.

    PubMed

    Matsumoto, Hiromi; Hagino, Hiroshi; Hayashi, Kunihiko; Ideno, Yuki; Wada, Takashi; Ogata, Toru; Akai, Masami; Seichi, Atsushi; Iwaya, Tsutomu

    2017-08-01

    This meta-analysis was performed to determine the effect of balneotherapy on relieving pain and stiffness and improving physical function, compared to controls, among patients with knee osteoarthritis. We searched electronic databases for eligible studies published from 2004 to December 31, 2016, with language restrictions of English or Japanese. We screened publications in Medline, Embase, Cochrane library, and the Japan Medical Abstracts Society Database using two approaches, MeSH terms and free words. Studies that examined the effect of balneotherapy for treating knee osteoarthritis of a ≥2-week duration were included. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used as the outcome measure. A total of 102 publications were assessed according to the exclusion criteria of the study; eight clinical trial studies, which comprised a total of 359 cases and 375 controls, were included in this meta-analysis. The meta-analysis analyzed improvement in WOMAC score at the final follow-up visit, which varied from 2 to 12 months post-intervention. Our meta-analysis indicates that balneotherapy was clinically effective in relieving pain and stiffness, and improving function, as assessed by WOMAC score, compared to controls. However, there was high heterogeneity (88 to 93%). It is possible that balneotherapy may reduce pain and stiffness, and improve function, in individuals with knee osteoarthritis, although the quality of current publications contributes to the heterogeneity observed in this meta-analysis.

  2. Comparative effectiveness of intra-articular prolotherapy versus peri-articular prolotherapy on pain reduction and improving function in patients with knee osteoarthritis: A randomized clinical trial.

    PubMed

    Farpour, Hamid Reza; Fereydooni, Farzane

    2017-11-01

    Osteoarthritis is a common degenerative disease. Prolotherapy is an alternative therapy used in multiple musculoskeletal disorders. To compare the effectiveness of intra-articular dextrose injection versus peri-articular prolotherapy in patients with knee osteoarthritis (KOA). Fifty-two adults with painful primary knee osteoarthritis for at least three months were randomized to intra- and peri-articular injection groups. Prolotherapy was done twice with two week intervals. The outcome measures included the Oxford Knee Scale (OKS), Western Ontario McMaster University Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS), which were obtained from patients before the first injection at the base line and after the second injection at the fourth and eighth weeks. There were no statistically significant differences between demographic characteristics; before the injection, pain intensity, OKS, and WOMAC scores were approximately equal between the two groups. After dextrose prolotherapy, VAS, OKS, and WOMAC scores improved from baseline through the fourth and eighth weeks in both groups without any superiority between the two methods of injections (p<0.001). Dextrose prolotherapy either intra- or peri-articular injection resulted in significant improvement, so it could be an inexpensive and effective management of knee osteoarthritis. The study protocol was registered as a clinical trial under registration ID of IRCT2016091229795N1 at the Iranian Registry of Clinical Trials (http://www.irct.ir). The authors received no financial support for the research, authorship, or publication of this article.

  3. Development of a Chinese version of the Western Ontario Meniscal Evaluation Tool: cross-cultural adaptation and psychometric evaluation.

    PubMed

    Tong, W W; Wang, W; Xu, W D

    2016-08-15

    The Western Ontario Meniscal Evaluation Tool (WOMET) is a questionnaire designed to evaluate the health-related quality of life (HRQOL) of patients with meniscal pathology. Our study aims to culturally adapt and validate the WOMET into a Chinese version. We translated the WOMET into Chinese. Then, a total of 121 patients with meniscal pathology were invited to participate in this study. To assess the test-retest reliability, the Chinese version WOMET was completed twice at 7-day intervals by the participants. The construct validity was assessed using Pearson's correlation coefficient or Spearman's correlation to test for correlations among the Chinese version WOMET and the eight domains of Short Form-36 (SF-36), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the International Knee Documentation Committee (IKDC) score. Responsiveness was tested by comparison of the preoperative and postoperative scores of the Chinese version WOMET. The test-retest reliability of the overall scale and different domains were all found to be excellent. The Cronbach's α was 0.90. The Chinese version WOMET correlated well with other questionnaires which suggested good construct validity. We observed no ceiling and floor effects of the Chinese version WOMET. We also found good responsiveness for the effect size, and the standardized response mean values were 0.86 and 1.11. The Chinese version of the WOMET appears to be reliable and valid in evaluating patients with meniscal pathology.

  4. Oxford Knee Score: cross-cultural adaptation and validation of the Turkish version in patients with osteoarthritis of the knee.

    PubMed

    Tuğay, Baki Umut; Tuğay, Nazan; Güney, Hande; Kınıklı, Gizem İrem; Yüksel, İnci; Atilla, Bülent

    2016-01-01

    The Oxford Knee Score (OKS) is a valid, short, self-administered, and site- specific outcome measure specifically developed for patients with knee arthroplasty. This study aimed to cross-culturally adapt and validate the OKS to be used in Turkish-speaking patients with osteoarthritis of the knee. The OKS was translated and culturally adapted according to the guidelines in the literature. Ninety-one patients (mean age: 55.89±7.85 years) with knee osteoarthritis participated in the study. Patients completed the Turkish version of the Oxford Knee Score (OKS-TR), Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Index (WOMAC) questionnaires. Internal consistency was tested using Cronbach's α coefficient. Patients completed the OKS-TR questionnaire twice in 7 days to determine the reproducibility. Correlation between the total results of both tests was determined by Spearman's correlation coefficient and intraclass correlation coefficients (ICC). Validity was assessed by calculating Spearman's correlation coefficient between the OKS, WOMAC, and SF-36 scores. Floor and ceiling effects were analyzed. Internal consistency was high (Cronbach's α: 0.90). The reproducibility tested by 2 different methods showed no significant difference (p>0.05). The construct validity analyses showed a significant correlation between the OKS and the other scores (p<0.05). There was no floor or ceiling effect in total OKS score. The OKS-TR is a reliable and valid measure for the self-assessment of pain and function in Turkish-speaking patients with osteoarthritis of the knee.

  5. The validation of the visual analogue scale for patient satisfaction after total hip arthroplasty.

    PubMed

    Brokelman, Roy B G; Haverkamp, Daniel; van Loon, Corné; Hol, Annemiek; van Kampen, Albert; Veth, Rene

    2012-06-01

    INTRODUCTION: Patient satisfaction becomes more important in our modern health care system. The assessment of satisfaction is difficult because it is a multifactorial item for which no golden standard exists. One of the potential methods of measuring satisfaction is by using the well-known visual analogue scale (VAS). In this study, we validated VAS for satisfaction. PATIENT AND METHODS: In this prospective study, we studied 147 patients (153 hips). The construct validity was measured using the Spearman correlation test that compares the satisfaction VAS with the Harris hip score, pain VAS at rest and during activity, Oxford hip score, Short Form 36 and Western Ontario McMaster Universities Osteoarthritis Index. The reliability was tested using the intra-class coefficient. RESULTS: The Pearson correlation test showed correlations in the range of 0.40-0.80. The satisfaction VAS had a high correlation between the pain VAS and Oxford hip score, which could mean that pain is one of the most important factors in patient satisfaction. The intra-class coefficient was 0.95. CONCLUSIONS: There is a moderate to mark degree of correlation between the satisfaction VAS and the currently available subjective and objective scoring systems. The intra-class coefficient of 0.95 indicates an excellent test-retest reliability. The VAS satisfaction is a simple instrument to quantify the satisfaction of a patient after total hip arthroplasty. In this study, we showed that the satisfaction VAS has a good validity and reliability.

  6. Different hip and knee priority score systems: are they good for the same thing?

    PubMed

    Escobar, Antonio; Quintana, Jose Maria; Espallargues, Mireia; Allepuz, Alejandro; Ibañez, Berta

    2010-10-01

    The aim of the present study was to compare two priority tools used for joint replacement for patients on waiting lists, which use two different methods. Two prioritization tools developed and validated by different methodologies were used on the same cohort of patients. The first, an IRYSS hip and knee priority score (IHKPS) developed by RAND method, was applied while patients were on the waiting list. The other, a Catalonia hip-knee priority score (CHKPS) developed by conjoint analysis, was adapted and applied retrospectively. In addition, all patients fulfilled pre-intervention the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Correlation between them was studied by Pearson correlation coefficient (r). Agreement was analysed by means of intra-class correlation coefficient (ICC), Kendall coefficient and Cohern kappa. The relationship between IHKPS, CHKPS and baseline WOMAC scores by r coefficient was studied. The sample consisted of 774 consecutive patients. Pearson correlation coefficient between IHKPS and CHKPS was 0.79. The agreement study showed that ICC was 0.74, Kendall coefficient 0.86 and kappa 0.66. Finally, correlation between CHKPS and baseline WOMAC ranged from 0.43 to 0.64. The results according to the relationship between IHKPS and WOMAC ranged from 0.50 to 0.74. Results support the hypothesis that if the final objective of the prioritization tools is to organize and sort patients on the waiting list, although they use different methodologies, the results are similar. © 2010 Blackwell Publishing Ltd.

  7. Portuguese-language version of the Chronic Respiratory Questionnaire: a validity and reproducibility study.

    PubMed

    Moreira, Graciane Laender; Pitta, Fábio; Ramos, Dionei; Nascimento, Cinthia Sousa Carvalho; Barzon, Danielle; Kovelis, Demétria; Colange, Ana Lúcia; Brunetto, Antonio Fernando; Ramos, Ercy Mara Cipulo

    2009-08-01

    To determine the validity and reproducibility of a Portuguese-language version of the Chronic Respiratory Questionnaire (CRQ) in patients with COPD. A Portuguese-language version of the CRQ (provided by McMaster University, the holder of the questionnaire copyright) was applied to 50 patients with COPD (70 +/- 8 years of age; 32 males; FEV1 = 47 +/- 18% of predicted) on two occasions, one week apart. The CRQ has four domains (dyspnea, fatigue, emotional function, and mastery) and was applied as an interviewer-administered instrument. The Saint George's Respiratory Questionnaire (SGRQ), already validated for use in Brazil, was used as the criterion for validation. Spirometry and the six-minute walk test (6MWT) were performed to analyze the correlations with the CRQ scores. There were no significant CRQ test-retest differences (p > 0.05 for all domains). The test-retest intraclass correlation coefficient was 0.98, 0.97, 0.98 and 0.95 for the dyspnea, fatigue, emotional function and mastery domains, respectively. The Cronbach's alpha coefficient was 0.91. The CRQ domains correlated significantly with the SGRQ domains (-0.30 < r < -0.67; p < 0.05). There were no significant correlations between spirometric variables and the CRQ domains or between the CRQ domains and the 6MWT, with the exception of the fatigue domain (r = 0.30; p = 0.04). The Portuguese-language version of the CRQ proved to be reproducible and valid for use in Brazilian patients with COPD.

  8. Comparison of the efficacy of physical therapy and corticosteroid injection in the treatment of pes anserine tendino-bursitis

    PubMed Central

    Sarifakioglu, Banu; Afsar, Sevgi Ikbali; Yalbuzdag, Seniz Akcay; Ustaömer, Kubra; Bayramoğlu, Meral

    2016-01-01

    [Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. [Subjects and Methods] Sixty patient with KOA and PATB (Group 1) and 57 patients with KOA but without PATB (Group 2) were enrolled in the study. The patients’ visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three-meter timed-up and go scores were measured. The PATB group was randomly divided into two groups (Group A and B). Physical therapy (PT) modalities were applied to the first group (Group A), and the second group (Group B) received corticosteroid injections to the pes anserine area. Eight weeks later, patients’ parameters were measured again. [Results] Initial WOMAC scores and timed up-and-go times were significantly higher in Group 1 than in Group 2. Both treatments resulted in significant improvements in all measured parameters, but no significant difference was detected between Group A and B. [Conclusion] Patients with PATB tend to have more severe pain, more altered functionality, and greater disability than those with KOA but without PATB. Both corticosteroid injection and PT are effective methods of treatment for PATB. Injection therapy can be considered an effective, inexpensive and fast therapeutic method. PMID:27512249

  9. Semiconductor Nanotechnology: Novel Materials and Devices for Electronics, Photonics, and Renewable Energy Applications

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Goodnick, Stephen; Korkin, Anatoli; Krstic, Predrag S

    2010-03-01

    Electronic and photonic information technology and renewable energy alternatives, such as solar energy, fuel cells and batteries, have now reached an advanced stage in their development. Cost-effective improvements to current technological approaches have made great progress, but certain challenges remain. As feature sizes of the latest generations of electronic devices are approaching atomic dimensions, circuit speeds are now being limited by interconnect bottlenecks. This has prompted innovations such as the introduction of new materials into microelectronics manufacturing at an unprecedented rate and alternative technologies to silicon CMOS architectures. Despite the environmental impact of conventional fossil fuel consumption, the low costmore » of these energy sources has been a long-standing economic barrier to the development of alternative and more efficient renewable energy sources, fuel cells and batteries. In the face of mounting environmental concerns, interest in such alternative energy sources has grown. It is now widely accepted that nanotechnology offers potential solutions for securing future progress in information and energy technologies. The Canadian Semiconductor Technology Conference (CSTC) forum was established 25 years ago in Ottawa as an important symbol of the intrinsic strength of the Canadian semiconductor research and development community, and the Canadian semiconductor industry as a whole. In 2007, the 13th CSTC was held in Montreal, moving for the first time outside the national capital region. The first three meetings in the series of Nano and Giga Challenges in Electronics and Photonics NGCM2002 in Moscow, NGCM2004 in Krakow, and NGC2007 in Phoenix were focused on interdisciplinary research from the fundamentals of materials science to the development of new system architectures. In 2009 NGC2009 and the 14th Canadian Semiconductor Technology Conference (CSTC2009) were held as a joint event, hosted by McMaster University (10 14

  10. EDITORIAL: Semiconductor nanotechnology: novel materials and devices for electronics, photonics and renewable energy applications Semiconductor nanotechnology: novel materials and devices for electronics, photonics and renewable energy applications

    NASA Astrophysics Data System (ADS)

    Goodnick, Stephen; Korkin, Anatoli; Krstic, Predrag; Mascher, Peter; Preston, John; Zaslavsky, Alex

    2010-04-01

    Electronic and photonic information technology and renewable energy alternatives, such as solar energy, fuel cells and batteries, have now reached an advanced stage in their development. Cost-effective improvements to current technological approaches have made great progress, but certain challenges remain. As feature sizes of the latest generations of electronic devices are approaching atomic dimensions, circuit speeds are now being limited by interconnect bottlenecks. This has prompted innovations such as the introduction of new materials into microelectronics manufacturing at an unprecedented rate and alternative technologies to silicon CMOS architectures. Despite the environmental impact of conventional fossil fuel consumption, the low cost of these energy sources has been a long-standing economic barrier to the development of alternative and more efficient renewable energy sources, fuel cells and batteries. In the face of mounting environmental concerns, interest in such alternative energy sources has grown. It is now widely accepted that nanotechnology offers potential solutions for securing future progress in information and energy technologies. The Canadian Semiconductor Technology Conference (CSTC) forum was established 25 years ago in Ottawa as an important symbol of the intrinsic strength of the Canadian semiconductor research and development community, and the Canadian semiconductor industry as a whole. In 2007, the 13th CSTC was held in Montreal, moving for the first time outside the national capital region. The first three meetings in the series of 'Nano and Giga Challenges in Electronics and Photonics'— NGCM2002 in Moscow, NGCM2004 in Krakow, and NGC2007 in Phoenix— were focused on interdisciplinary research from the fundamentals of materials science to the development of new system architectures. In 2009 NGC2009 and the 14th Canadian Semiconductor Technology Conference (CSTC2009) were held as a joint event, hosted by McMaster University (10

  11. Cross-Cultural adaptation of the General Functioning Scale of the Family.

    PubMed

    Pires, Thiago; Assis, Simone Gonçalves de; Avanci, Joviana Quintes; Pesce, Renata Pires

    2016-06-27

    To describe the process of cross-cultural adaptation of the General Functioning Scale of the Family, a subscale of the McMaster Family Assessment Device, for the Brazilian population. The General Functioning Scale of the Family was translated into Portuguese and administered to 500 guardians of children in the second grade of elementary school in public schools of Sao Gonçalo, Rio de Janeiro, Southeastern Brazil. The types of equivalences investigated were: conceptual and of items, semantic, operational, and measurement. The study involved discussions with experts, translations and back-translations of the instrument, and psychometric assessment. Reliability and validity studies were carried out by internal consistency testing (Cronbach's alpha), Guttman split-half correlation model, Pearson correlation coefficient, and confirmatory factor analysis. Associations between General Functioning of the Family and variables theoretically associated with the theme (father's or mother's drunkenness and violence between parents) were estimated by odds ratio. Semantic equivalence was between 90.0% and 100%. Cronbach's alpha ranged from 0.79 to 0.81, indicating good internal consistency of the instrument. Pearson correlation coefficient ranged between 0.303 and 0.549. Statistical association was found between the general functioning of the family score and the theoretically related variables, as well as good fit quality of the confirmatory analysis model. The results indicate the feasibility of administering the instrument to the Brazilian population, as it is easy to understand and a good measurement of the construct of interest. Descrever o processo de adaptação transcultural da escala de Funcionamento Geral da Família, subescala da McMaster Family Assessment Device, para a população brasileira. A escala de Funcionamento Geral da Família, original no idioma inglês, foi traduzida para o português e aplicada a 500 responsáveis de crianças do segundo ano do ensino

  12. Motherhood during residency training: challenges and strategies.

    PubMed

    Walsh, Allyn; Gold, Michelle; Jensen, Phyllis; Jedrzkiewicz, Michelle

    2005-07-01

    To determine what factors enable or impede women in a Canadian family medicine residency program from combining motherhood with residency training. To determine how policies can support these women, given that in recent decades the number of female family medicine residents has increased. Qualitative study using in-person interviews. McMaster University Family Medicine Residency Program. Twenty-one of 27 family medicine residents taking maternity leave between 1994 and 1999. Semistructured interviews. The research team reviewed transcripts of audiotaped interviews for emerging themes; consensus was reached on content and meaning. NVIVO software was used for data analysis. Long hours, unpredictable work demands, guilt because absences from work increase workload for colleagues, and residents' high expectations of themselves cause pregnant residents severe stress. This stress continues upon return to work; finding adequate child care is an added stress. Residents report receiving less support from colleagues and supervisors upon return to work; they associate this with no longer being visibly pregnant. Physically demanding training rotations put additional strain on pregnant residents and those newly returned to work. Flexibility in scheduling rotations can help accommodate needs at home. Providing breaks, privacy, and refrigerators at work can help maintain breastfeeding. Allowing residents to remain involved in academic and clinical work during maternity leave helps maintain clinical skills, build new knowledge, and promote peer support. Pregnancy during residency training is common and becoming more common. Training programs can successfully enhance the experience of motherhood during residency by providing flexibility at work to facilitate a healthy balance among the competing demands of family, work, and student life.

  13. Effects of Meditation on Symptoms of Knee Osteoarthritis

    PubMed Central

    Selfe, Terry Kit; Innes, Kim E.

    2014-01-01

    Objective The aim of this study was to investigate changes in knee pain, function, and related indices in older adults with osteoarthritis (OA) of the knee, following an 8-week meditation program. Methods Eleven community-dwelling adults with physician- confirmed knee OA were enrolled in the study. Core outcomes included recommended measures of knee pain (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] and 11-point numeric rating scale [NRS]), function (WOMAC), and perceived global status (patient global assessment). Additional outcomes included: perceived stress; stress hardiness; mood; sleep; and sympathetic activation. Following baseline assessment, participants were trained briefly in mantra meditation and instructed to meditate for 15–20 minutes twice daily for 8 weeks, and to record each practice session on a daily log. Changes over time were analyzed using paired t-tests. Results Nine participants (82%) completed the study. Participants had statistically significant improvements in all core outcomes: knee pain (WOMAC: 47.7% ± 25.1% reduction, P = 0.001; NRS: 42.6% ± 34.6% reduction, P < 0.01); function (44.8% ± 29.9, P = 0.001); and global status (45.7% ± 36.5, P = 0.01); as well as knee stiffness (P = 0.005), mood (P = 0.05), and a WOMAC proxy for sleep disturbance (P = 0.005). Conclusions Findings from this pilot study suggest that a mantra meditation program may help reduce knee pain and dysfunction, as well as improving mood and related outcomes in adults with knee OA. PMID:26549967

  14. The relationship between family functioning and the crime types in incarcerated children.

    PubMed

    Teker, Kamil; Topçu, Seda; Başkan, Sevgi; Orhon, Filiz Ş; Ulukol, Betül

    2017-06-01

    We investigated the relationship between the family functioning and crime types in incarcerated children. One hundred eighty two incarcerated children aged between 13-18 years who were confined in child-youth prisons and child correctional facilities were enrolled into this descriptive study. Participants completed demographic questions and the McMaster Family Assessment Device (Epstein, Baldwin, & Bishop, 1983) (FAD) with face to face interviews. The crime types were theft, assault (bodily injury), robbery, sexual assault, drug trafficker and murder. The socio-demographic characteristics were compared by using FAD scale, and growing up in a nuclear family had statistically significant better scores for problem solving and communication subscales and the children whose parents had their own house had significantly better problem solving scores When we compared the crime types of children by using problem solving, communication and general functioning subscales of FAD, we found statistical lower scores in assault (bodily injury) group than in theft, sexual assault, murder groups and in drug trafficker group than in murder group, also we found lower scores in drug trafficker group than in theft group for problem solving and general functioning sub-scales, also there were lower scores in bodily injury assault group than in robbery, theft groups and in drug trafficker than in theft group for problem solving subscale. The communication and problem solving sub-scales of FAD are firstly impaired scales for the incarcerated children. We mention these sub-scales are found with unplanned and less serious crimes and commented those as cry for help of the children.

  15. Clinical and radiographic outcomes of medial open-wedge high tibial osteotomy with Anthony-K plate: prospective minimum five year follow-up data.

    PubMed

    Altay, Mehmet Akif; Ertürk, Cemil; Altay, Nuray; Mercan, Ahmet Şükrü; Sipahioğlu, Serkan; Kalender, Ali Murat; Işıkan, Uğur Erdem

    2016-07-01

    The purpose of this study was to prospectively evaluate the clinical and radiographic outcomes, and complication rates, after a minimum of five years of follow-up after medial open wedge high tibial osteotomy (MOWHTO) using an Anthony-K plate. MOWHTO was performed on 35 knees of 34 consecutive patients. A visual analogue scale (VAS), and Western Ontario and McMaster University Osteoarthritis (WOMAC) and Lysholm scores, were used in clinical evaluation. Upon radiographic assessment, alignment was expressed as the femorotibial angle (FTA). The posterior tibial slope (PTS) and the Insall-Salvati Index (ISI) were also measured. VAS, WOMAC, and Lysholm scores improved significantly upon follow-up (p < 0.001 for all). The overall mean FTA was 4.68 ± 4.39° varus pre-operatively; at the last post-operative follow-up, the value was 8.43 ± 2.02° valgus. The mean correction angle was 13.1 ± 2.7°. A significant increase in PTS was evident (p < 0.01), as was a significant decrease in the ISI (p < 0.01). The overall complication rate was 8.6 %. The Anthony-K plate affords accurate correction, initially stabilises the osteotomy after surgery, and maintains such stability until the osteotomy gap is completely healed, without correction loss. The plate survival rate was 97.2 % after a minimum of five years of follow-up. The plate increased the PTS, as do other medial osteotomy fixation plates.

  16. Tibial condylar valgus osteotomy (TCVO) for osteoarthritis of the knee: 5-year clinical and radiological results.

    PubMed

    Chiba, Ko; Yonekura, Akihiko; Miyamoto, Takashi; Osaki, Makoto; Chiba, Goji

    2017-03-01

    Tibial condylar valgus osteotomy (TCVO) is a type of opening-wedge high tibial osteotomy for advanced medial knee osteoarthritis (OA) with subluxated lateral joint. We report the concept, the current surgical technique with a locking plate, and the short-term clinical and radiological results of this procedure. 11 knees with medial OA and a widened lateral joint were treated by TCVO (KL stage III: 6, IV: 5). In this procedure, by the L-shaped osteotomy from the medial side of the proximal tibia to the intercondylar eminence and the valgus correction, lateralization of the mechanical axis and reduction of the subluxated lateral joint are obtained with early postoperative weight-bearing. Before, 6 months, 1, and 5 years after the operation, a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), alignment of the lower extremity, and congruency and stability of the femorotibial joint were investigated. The VAS improved from an average of 73 mm to 13 mm, and the total WOMAC score from 52 to 14 before to 5 years after the operation, respectively. The mechanical axis changed from 1 to 60%, and the FTA changed from 186° to 171°. The joint line convergence angle (JLCA) changed from 6° to 1°, and the angle difference of JLCA between varus and valgus stress improved from 8° to 4° after the procedure. Improvements in pain and activities of daily living were observed by TCVO along with valgus correction of the lower extremity and stabilization of the femorotibial joint.

  17. Podcast Use in Undergraduate Medical Education

    PubMed Central

    Helman, Anton; Chan, Teresa M

    2017-01-01

    Introduction Podcasts have become increasingly popular as a medium for free open access medical education (FOAM). However, little research has examined the use of these extracurricular audio podcasts as tools in undergraduate medical education. We aimed to examine knowledge retention, usage conditions, and preferences of undergraduate medical students at a Canadian university interacting with extracurricular podcasts. Methods Students enrolled in the undergraduate medical program at McMaster University volunteered to participate in this study. Two podcasts were created specifically for the purposes of this study, and online tests and surveys were sent to participants to gather data regarding user preferences of podcasts. In addition, we recorded changes in topic test scores before and after podcast exposure. Results Forty-two students were recruited to this study. Participants who completed the assessments demonstrated an effect of learning. Podcasts of 30 minutes or less were preferred in the majority of participants who had a preference in duration. The top three activities participants were engaged in while listening to the podcasts were driving (46%), completing chores (26%), and exercising (23%). A large number of participants who did not complete the study in its entirety cited a lack of time and podcast length to be the top two barriers to completion. Conclusion This is one of the first studies to examine extracurricular podcast-usage data and preferences in a Canadian undergraduate medical student population. This information may help educators and FOAM producers to optimize educational tools for medical education. PMID:29464137

  18. Leadership training in a family medicine residency program

    PubMed Central

    Gallagher, Erin; Moore, Ainsley; Schabort, Inge

    2017-01-01

    Abstract Objective To assess the current status of leadership training as perceived by family medicine residents to inform the development of a formal leadership curriculum. Design Cross-sectional quantitative survey. Setting Department of Family Medicine at McMaster University in Hamilton, Ont, in December 2013. Participants A total of 152 first- and second-year family medicine residents. Main outcome measures Family medicine residents’ attitudes toward leadership, perceived level of training in various leadership domains, and identified opportunities for leadership training. Results Overall, 80% (152 of 190) of residents completed the survey. On a Likert scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree), residents rated the importance of physician leadership in the clinical setting as high (6.23 of 7), whereas agreement with the statement “I am a leader” received the lowest rating (5.28 of 7). At least 50% of residents desired more training in the leadership domains of personal mastery, mentorship and coaching, conflict resolution, teaching, effective teamwork, administration, ideals of a healthy workplace, coalitions, and system transformation. At least 50% of residents identified behavioural sciences seminars, a lecture and workshop series, and a retreat as opportunities to expand leadership training. Conclusion The concept of family physicians as leaders resonated highly with residents. Residents desired more personal and system-level leadership training. They also identified ways that leadership training could be expanded in the current curriculum and developed in other areas. The information gained from this survey might facilitate leadership development among residents through application of its results in a formal leadership curriculum. PMID:28292816

  19. A single-group pretest posttest design using full kinetic chain manipulative therapy with rehabilitation in the treatment of 18 patients with hip osteoarthritis.

    PubMed

    Brantingham, James W; Globe, Gary A; Cassa, Tammy Kay; Globe, Denise; de Luca, Katie; Pollard, Henry; Lee, Felix; Bates, Charles; Jensen, Muffit; Mayer, Stephan; Korporaal, Charmaine

    2010-01-01

    Hip osteoarthritis (HOA) affects 30 million Americans or more, and is a leading cause of disability, suffering, and pain. Standard treatments are minimally effective and carry significant risk and expense. This study assessed treatment effects of a chiropractic protocol for HOA. Eighteen individuals, who did not qualify due to low baseline Western Ontario and McMaster Osteoarthritis Index scores (WOMAC) for other ongoing HOA randomized control trials, were selected. A prospectively planned protocol, consisting of axial manipulation to the affected hip with modified Thomas and active assisted stretch, was combined with full kinetic chain treatment or manipulative therapy to the spine, knee, ankle, or foot and assessed with use of valid and reliable outcome measures. The primary outcome measure, the Overall Therapy Effectiveness Tool, was assessed with chi(2) and demonstrated that 83.33% of participants were improved after the ninth visit, P = .005, and 78% improved at the 3-month follow-up, P = .018. Using the paired t test, WOMAC was improved 64% at the ninth visit, P = .000, and 47% at follow-up, P = .016. In HOA patients with lower WOMAC scores, a highly organized HOA treatment appears to have resulted in statistically and clinically meaningful intragroup changes in the Overall Effectiveness Therapy Tool, WOMAC, Harris Hip Scale, and range of motion, all with P

  20. Physiological Indices of Stress Prior to and Following Total Knee Arthroplasty Predict the Occurrence of Severe Post-Operative Pain.

    PubMed

    Cremeans-Smith, Julie K; Greene, Kenneth; Delahanty, Douglas L

    2016-05-01

    The severe pain and disability associated with osteoarthritis often motivate individuals to undergo arthroplastic surgery. However, a significant number of surgical patients continue to experience pain following surgery. Prior research has implicated both the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) in the sensitization of pain receptors and chronic pain conditions. This study uses a prospective, observational, cohort design to examine whether physiological stress responses before and after surgery could predict post-operative pain severity. Participants included 110 patients undergoing total knee arthroplasty. Physiological indices of stress included the measurement of catecholamine and cortisol levels in 15-hour urine samples collected prior to and 1 month following surgery, as well as in-hospital heart rate and blood pressure (before and after surgery), which were abstracted from medical records. Patients completed the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Bellamy et al., J Orthop Rheumatol 1: , 95 (1988)] 2.5 weeks prior to surgery and at a 3-month follow-up. Contrary to expectations, lower stress hormone levels at baseline were related to more severe post-operative pain. Data at later time points, however, supported our hypothesis: cardiovascular tone shortly before surgery and urinary levels of epinephrine 1 month following surgery were positively related to pain severity 3 months later. Results suggest that the occurrence of post-operative pain can be predicted on the basis of stress physiology prior to and following arthroplastic surgery. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Depression and Pain in Asian and White Americans With Knee Osteoarthritis.

    PubMed

    Ahn, Hyochol; Weaver, Michael; Lyon, Debra; Choi, Eunyoung; Fillingim, Roger B

    2017-10-01

    Few studies have examined the underlying psychosocial mechanisms of pain in Asian Americans. Using the biopsychosocial model, we sought to determine whether variations in depression contribute to racial group differences in symptomatic knee osteoarthritis pain between Asian Americans and non-Hispanic white Americans. The sample consisted of 100 participants, including 50 Asian Americans (28 Korean Americans, 9 Chinese Americans, 7 Japanese Americans, 5 Filipino Americans, and 1 Indian American) and 50 age- and sex-matched non-Hispanic white Americans with symptomatic knee osteoarthritis pain. The Centers for Epidemiologic Studies Depression Scale was used to assess symptoms of depression, and the Western Ontario and McMaster Universities Osteoarthritis Index and the Graded Chronic Pain Scale were used to measure clinical pain. In addition, quantitative sensory testing was used to measure experimental sensitivity to heat- and mechanically-induced pain. The results indicated that higher levels of depression in Asian Americans may contribute to greater clinical pain and experimental pain sensitivity. These findings add to the growing literature regarding ethnic and racial differences in pain and its associated psychological conditions, and additional research is warranted to strengthen these findings. This article shows the contribution of depression to clinical pain and experimental pain sensitivity in Asian Americans with knee osteoarthritis. Our results suggest that Asian Americans have higher levels of depressive symptoms and that depression plays a relevant role in greater clinical pain and experimental pain sensitivity in Asian Americans. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  2. The effectiveness of mindfulness meditation for nurses and nursing students: An integrated literature review.

    PubMed

    van der Riet, Pamela; Levett-Jones, Tracy; Aquino-Russell, Catherine

    2018-06-01

    A growing body of literature has identified a range of beneficial physiological and psychological outcomes from the regular practice of mindfulness meditation. For healthcare professionals, mindfulness meditation is claimed to reduce stress, anxiety and burnout, and enhance resilience. The objective of this integrative review was to critically appraise the literature that related to the effectiveness of mindfulness meditation programs for nurses and nursing students. This review was conducted using Whittemore and Knafl's framework for integrated reviews. Using the terms mindfulness, mindfulness-based-stress reduction, Vipassana, nurses, and nurse education a comprehensive search of the following electronic databases was conducted: CINAHAL, Medline, PsycINFO, EMBASE. EMCARE, ERIC and SCOPUS. The initial search located 1703 articles. After screening and checking for eligibility 20 articles were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers and McMaster's Critical appraisal form for quantitative papers. The final number of papers included in the review was 16. The results of this review identified that mindfulness meditation has a positive impact on nurses' and nursing students' stress, anxiety, depression, burnout, sense of well-being and empathy. However, the majority of the papers described small scale localised studies which limits generalisability. Contemporary healthcare is challenging and complex. This review indicated that mindfulness meditation is an effective strategy for preventing and managing the workplace stress and burnout, which so often plague nursing staff and students. Further studies with larger sample sizes using rigorous research methods would be useful in extending this work. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. The 26gAl(p,g)27Si reaction in Novae

    NASA Astrophysics Data System (ADS)

    Ruiz, Chris; Parikh, A.; José, J.; Buchmann, L.; Caggiano, J. A.; Chen, A. A.; Clark, J. A.; Crawford, H.; Davids, B.; D'Auria, J. M.; Davis, C.; Deibel, C.; Erikson, L.; Fogarty, L.; Frekers, D.; Greife, U.; Hussein, A.; Hutcheon, D. A.; Huyse, M.; Jewett, C.; Laird, A. M.; Lewis, R.; Mumby-Croft, P.; Olin, A.; Ottewell, D. F.; Ouellet, C. V.; Parker, P.; Pearson, J.; Ruprecht, G.; Trinczek, M.; Vockenhuber, C.; Wrede, C.

    The 26gAl(p,γ)27Si Reaction in Novae PoS(NIC-IX)004 1 TRIUMF, 4004 Wesbrook Mall, Vancouver, BC V6T 2A3, Canada 2 Wright Nuclear Structure Laboratory, Yale University, New Haven, Conneticut 06520-8124, USA 3 Dept. de Física í Enginyeria Nuclear, Universitat Politécnica de Catalunya, Barcelona, Spain 4 Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona, Spain 5 McMaster University, Hamilton, ON L8S 481, Canada 6 Simon Fraser University, Burnaby, BC V5A 1S6, Canada 7 Department of Physics, Colorado School of Mines, Golden, Colorado 80401, USA 8 National University of Ireland, Maynooth, Co. Kildare, Ireland 9 Institut für Kernphysik, Westfälische Willhelms-Universität Münster, 48149 Münster, Germany 10 University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada 11 Katholieke Universiteit Leuven, 3000 Leuven, Belgium 12 Department of Physics, University of York, York YO10 5DD, United Kingdom The 184 keV resonance strength in the 26gAl(p,γ)27Si reaction was measured in inverse kinematics using the DRAGON facility at TRIUMF-ISAC. We obtain a value of ωγ=35±7 μeV for the strength and ER=184±1 keV for the resonance energy. These values are consistent with p-wave capture into the 7652(3) keV state in 27Si. We discuss the implications of these results for 26gAl nucleosynthesis in a typical O-Ne white dwarf nova.

  4. Depression and anxiety before and after limb length discrepancy correction in patients with unilateral developmental dysplasia of the hip.

    PubMed

    Liu, Ruiyu; Li, Yongwei; Fan, Lihong; Mu, Mingchao; Wang, Kunzheng; Song, Wei

    2015-12-01

    Limb length discrepancy (LLD) is common in patients with developmental dysplasia of the hip (DDH) and may influence the psychological status of these patients. The present study aims to investigate depression and anxiety in DDH patients with different extents of LLD and to assess the effect of LLD correction on these two psychological factors. 161 patients with DDH were recruited and divided into two groups based on whether they could perceive LLD preoperatively. The patients who could not perceive LLD were assigned to group N, and those who could perceive LLD were assigned to group P. Depression/anxiety, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and LLD were assessed one week before, six months and two years after total hip arthroplasty (THA). Depression and anxiety were significantly higher in group P patients compared to group N patients. The patients in group N presented significant improvement in depression and anxiety six months after arthroplasty, while DDH patients in group P did two years after arthroplasty. Correlation analyses revealed their improvement was associated with pain relief and improved hip function in both groups of patients and was also related to changes in the perception of LLD in group P patients. Depression and anxiety levels were higher in DDH patients with perceived LLD. Their improvement was related to pain relief and improved hip function following THA. In DDH patients with perceived LLD, a change in the perception of LLD also played a part in their improvement. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Unloading shoes for osteoarthritis of the knee: protocol for the SHARK randomised controlled trial

    PubMed Central

    2014-01-01

    Background Knee osteoarthritis (OA) is a common and disabling condition. Abnormalities in knee loading play an important role in disease pathogenesis, yet there are few non-surgical treatments for knee OA capable of reducing knee load. This two-arm randomised controlled trial is investigating the efficacy of specially-designed unloading shoes for the treatment of symptoms in people with knee OA. Methods/Design 164 people with symptomatic medial tibiofemoral joint OA will be recruited from the community and randomly allocated to receive either unloading shoes or control shoes. Unloading shoes have a specially-designed triple-density midsole where the medial side is softer than normal and the lateral side harder as well as a lateral wedge between the sole and sock-liner. Control shoes are standard athletic shoes and do not contain these features. Participants will be blinded to shoe allocation and will be instructed to wear the shoes as much as possible every day for 6 months, for a minimum of 4 hours per day. The primary outcomes are knee pain (numerical rating scale) and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index) measured at baseline and 6 months. Secondary outcomes include additional measures of knee pain, knee stiffness, participant global ratings of change in symptoms, quality-of-life and physical activity. Conclusions The findings from this study will help determine whether specially-designed unloading shoes are efficacious in the management of knee OA. Trial registration Australian New Zealand Clinical Trials Registry reference: ACTRN12613000851763. PMID:24555418

  6. Semimembranosus Release for Medial Soft Tissue Balancing Does Not Weaken Knee Flexion Strength in Patients Undergoing Varus Total Knee Arthroplasty.

    PubMed

    Jang, Sung Won; Koh, In Jun; Kim, Man Soo; Kim, Ju Yeong; In, Yong

    2016-11-01

    The sequential medial release technique including semimembranosus (semiM) release is effective and safe during varus total knee arthroplasty (TKA). However, there are concerns about weakening of knee flexion strength after semiM release. We determined whether semiM release to balance the medial soft tissue decreased knee flexion strength after TKA. Fifty-nine consecutive varus knees undergoing TKA were prospectively enrolled. A 3-step sequential release protocol which consisted of release of (1) the deep medial collateral ligament (dMCL), (2) the semiM, and (3) the superficial medial collateral ligament based on medial tightness. Gap balancing was obtained after dMCL release in 31 knees. However, 28 knees required semiM release or more after dMCL release. Isometric muscle strength of the knee was compared 6 months postoperatively between the semiM release and semiM nonrelease groups. Knee stability and clinical outcomes were also compared. No differences in knee flexor or extensor peak torque were observed between the groups 6 months postoperatively (P = .322 and P = .383, respectively). No group difference was observed in medial joint opening angle on valgus stress radiographs (P = .327). No differences in the Knee Society or Western Ontario and McMaster Universities Osteoarthritis Index scores were detected between the groups (P = .840 and P = .682, respectively). These results demonstrate that semiM release as a sequential step to balance medial soft tissue in varus knees did not affect knee flexion strength after TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Manipulation under anaesthesia versus low stretch device in poor range of motion after TKA.

    PubMed

    Witvrouw, E; Bellemans, J; Victor, J

    2013-12-01

    The purpose of this study was to evaluate the effectiveness of two frequently used non-operative treatment techniques for a stiff knee after total knee arthroplasty. Sixty-four patients with a stiff knee after total knee arthroplasty (TKA) were randomized into a manipulation under anaesthesia group, or a low load stretch (stretch) group. The patients were followed up for 6 weeks and were evaluated for maximum flexion and extension, range of motion (ROM), pain, stiffness and function. Both groups showed a significant increase in knee flexion in this study. Only the stretch group showed a significant increase in extension ROM. In both groups, a significant increase in Western Ontario and McMaster Universities was observed. No significant difference was observed between both groups for the flexion or extension ROM, or for any of the pain, function or stiffness scores during this study. The results of this study showed that the stretch technique had equal or superior results concerning ROM and function compared to manipulation under anaesthesia. The stretch technique achieved this without requiring the patient to undergo in-hospital treatment or anaesthesia, limiting the costs and the risks for complications. The results of this study showed that stretching is a valuable tool for treating joint contractures of the knee. Therefore, the use of this stretching technique may be an excellent first choice of treatment modality in patients with slow progress of knee flexion or persistent knee stiffness following TKA, prior to manipulation under anaesthesia or lysis of adhesions.

  8. The Morscher Press-Fit Acetabular Component: An Independent Long-Term Review at 18-22 Years.

    PubMed

    Gwynne-Jones, David P; Lash, Heath W R; James, Andrew W; Iosua, Ella E; Matheson, John A

    2017-08-01

    There are relatively few 20-year results of uncemented acetabular components, and most of these are modular designs. This study reports the 20-year results of a monoblock press-fit acetabular component. A total of 122 total hip arthroplasties (111 patients) using the Morscher cup were reviewed at a mean of 19.7 years. The average age at implantation was 57.3 years (range, 36-74 years), and 81 (66%) were men. Twenty-two patients (25 hips) had died. Seven hips were revised, including 5 acetabular revisions. Six patients (6 hips) declined to participate but were known not to have been revised. The mean Oxford hip score was 41.1 (range, 22-48), and the mean reduced Western Ontario and McMaster Universities Osteoarthritis Index score was 5.7/48 (range, 0-24). Eccentric wear was seen in 13 (15.7%) and major osteolysis in 14 (17%) of 82 surviving hips with radiographs. The all-cause revision rate was 0.32 per 100 observed component years (95% confidence interval [CI], 0.13-0.66). The 20-year Kaplan-Meier survival was 93.4% (CI, 86.6-96.8) for all-cause revisions, 95.5% (CI, 89.4-98.1) for any acetabular revision, and 97.1% (CI, 91.2-99.1) for acetabular aseptic loosening, wear, or osteolysis. The Morscher acetabular component has continued to perform well at 20 years despite using conventional polyethylene with results that match or surpass other cementless acetabulae. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Impact of field of study, college and year on calculation of cumulative grade point average.

    PubMed

    Trail, Carla; Reiter, Harold I; Bridge, Michelle; Stefanowska, Patricia; Schmuck, Marylou; Norman, Geoff

    2008-08-01

    A consistent finding from many reviews is that undergraduate Grade Point Average (uGPA) is a key predictor of academic success in medical school. Curiously, while uGPA has established predictive validity, little is known about its reliability. For a variety of reasons, medical schools use different weighting schemas to combine years of study. Additional concerns relate to the equivalence of grades obtained from different fields of study and institutions, with little hard data to guide conclusions. At the Michael G. DeGroote School of Medicine Class of 2007 at McMaster University, every undergraduate grade of 2,138 applicants, along with field of study and post-secondary educational institution, was analyzed. Individual grades were aggregated into an overall uGPA using published algorithms from several medical school, and correlated with a non-weighted sum. Correlations of the different schemas with equal weights ranged from 0.973 to 0.990. The extent of the difference between fields of study was small, accounting for only 1.5% of the variance. However, differences among 16 Ontario universities were larger, and accounted for 9.3% of the variance. The results of this study suggest that all weighting schemas are virtually equivalent, making any formulation reasonable. Differences by field of study are small, but do not show any bias against non-science students. Differences by institution are larger, amounting to a range in average score from 78.7 to 84.6; however it is not clear whether this reflects candidate ability or institutional policy, so attempts to correct for institution may be difficult.

  10. A study of psychological symptoms, family function, marital and life satisfactions of polygamous and monogamous women: the Palestinian case.

    PubMed

    Al-Krenawi, Alean

    2012-01-01

    Polygamy is defined as a marriage in which a spouse of either gender has more than one mate at the same time. Polygamy is considered a valid form of marriage in many countries and communities around the globe. The purpose of this study is to examine the psychological symptoms, family function, marital satisfaction, life satisfaction and the degree of agreement with the practice of polygamy among 'senior wives' - the first wife in the polygamous marriage - and women in monogamous marriages in the West Bank, Palestine. A convenience sample of 309 women, 187 from polygamous and 122 from monogamous families, participated in this study. All women from polygamous families were senior wives. The following instruments were deployed: the McMaster Family Assessment Device (FAD), the ENRICH marital satisfaction questionnaire, the SCL-90 mental health symptoms checklist, the Rosenberg self-esteem (SE) scale, the Diener et al. (1985), a life satisfaction scale, and a basic socio-demographic scale, including the degree of agreement of the practice of polygamy. The findings revealed significant differences between senior wives in polygamous marriages and wives in monogamous marriages with regard to family functioning, marital satisfaction, self-esteem and life satisfaction. Likewise, many of the mental health symptoms were different. Particularly noteworthy were somatization, depression, hostility psychotism and the General Severity Index (a global index of distress). More women in polygamous marriages agreed with the practice of polygamy than their monogamous counterparts. Practitioners and policy makers need to be aware of the consequences of polygamy on first wives and on society as whole.

  11. Getting Better or Getting Well? The Patient Acceptable Symptom State (PASS) Better Predicts Patient's Satisfaction than the Decrease of Pain, in Knee Osteoarthritis Subjects Treated with Viscosupplementation.

    PubMed

    Conrozier, Thierry; Monet, Matthieu; Lohse, Anne; Raman, Raghu

    2017-08-01

    Background In the management of knee osteoarthritis (OA), patient-reported-outcomes (PROs) are being developed for relevant assessment of pain. The patient acceptable symptom state (PASS) is a relevant cutoff, which allows classifying patients as being in "an acceptable state" or not. Viscosupplementation is a therapeutic modality widely used in patients with knee OA that many patients are satisfied with despite meta-analyses give conflicting results. Objectives To compare, 6 months after knee viscosupplementation, the percentage of patients who reached the PASS threshold (PASS +) with that obtained from other PROs. Methods Data of 53 consecutive patients treated with viscosupplementation (HANOX-M-XL) and followed using a standardized procedure, were analyzed at baseline and month 6. The PROs were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function, patient's global assessment of pain (PGAP), patient's self-assessment of satisfaction, PASS for WOMAC pain and PGAP. Results At baseline, WOMAC pain and PGAP (range 0-10) were 4.6 (1.1) and 6.0 (1.1). At month 6, they were 1.9 (1.2) and 3.1 (5) ( P < 0.0001). At 6 months, 83% of patients were "PASS + pain," 100% "PASS + function," 79% "PASS + PGAP," 79% were satisfied, and 73.6% experienced a ≥50% decrease in WOMAC pain. Among "PASS + pain" and "PASS + PGAP" subjects, 90% and 83.3% were satisfied with the treatment, respectively. Conclusion In daily practice, clinical response to viscosupplementation slightly varies according to PROs. "PASS + PGAP" was the most related to patient satisfaction.

  12. Magnetic and Crystal Structure of α-RuCl3

    NASA Astrophysics Data System (ADS)

    Sears, Jennifer

    The layered honeycomb material α-RuCl3 has been proposed as a candidate material to show significant bond-dependent Kitaev type interactions. This has prompted several recent studies of magnetism in this material that have found evidence for multiple magnetic transitions in the temperature range of 8-14 K. We will present elastic neutron scattering measurements collected using a co-aligned array of α-RuCl3 crystals, identifying zigzag magnetic order within the honeycomb planes with an ordering temperature of ~8 K. It has been reported that the ordering temperature depends on the c axis periodicity of the layered structure, with ordering temperatures of 8 and 14 K for three and two-layer periodicity respectively. While the in-plane magnetic order has been identified, it is clear that a complete understanding of magnetic ordering and interactions will depend on the three dimensional structure of the crystal. Evidence of a structural transition at ~150 K has been reported and questions remain about the structural details, in particular the stacking of the honeycomb layers. We will present x-ray diffraction measurements investigating the low and high temperature structures and stacking disorder in α-RuCl3. Finally, we will present inelastic neutron scattering measurements of magnetic excitations in this material. Work done in collaboration with K. W. Plumb (Johns Hopkins University), J. P. Clancy, Young-June Kim (University of Toronto), J. Britten (McMaster University), Yu-Sheng Chen (Argonne National Laboratory), Y. Qiu, Y. Zhao, D. Parshall, and J. W. Lynn (NCNR).

  13. Validation study of the Forgotten Joint Score-12 as a universal patient-reported outcome measure.

    PubMed

    Matsumoto, Mikio; Baba, Tomonori; Homma, Yasuhiro; Kobayashi, Hideo; Ochi, Hironori; Yuasa, Takahito; Behrend, Henrik; Kaneko, Kazuo

    2015-10-01

    The Forgotten Joint Score-12 (FJS-12) is for patients to forget their artificial joint and is reportedly a useful patient-reported outcome tool for artificial joints. The purpose of this study was to determine whether the FJS-12 is as useful as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) or the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) in Japan. All patients who visited our hospital's hip joint specialists following unilateral THA from August 2013 to July 2014 were evaluated. Medical staff members other than physicians administered three questionnaires. Items evaluated were (1) the reliability of the FJS-12 and (2) correlations between the FJS-12 and the total and subscale scores of the WOMAC or JHEQ. Of 130 patients, 22 were excluded. Cronbach's α coefficient was 0.97 for the FJS-12. The FJS-12 showed a significantly lower score than the WOMAC or JHEQ (p < 0.01). The FJS-12 was moderately correlated with the total WOMAC score (r = 0.522) and its subscale scores for "stiffness" (r = 0.401) and "function" (r = 0.539) and was weakly correlated with the score for "pain" (r = 0.289). The FJS-12 was favorably correlated with the total JHEQ score (r = 0.686) and its subscale scores (r = 0.530-0.643). The FJS-12 was correlated with and showed reliability similar to that of the JHEQ and WOMAC. The FJS-12, which is not affected by culture or lifestyle, may be useful in Japan.

  14. Knee joint laxity does not moderate the relationship between quadriceps strength and physical function in knee osteoarthritis patients: A cross-sectional study.

    PubMed

    Altubasi, Ibrahim M

    2018-06-07

    Knee osteoarthritis is a common and a disabling musculoskeletal disorder. Patients with knee osteoarthritis have activity limitations which are linked to the strength of the quadriceps muscle. Previous research reported that the relationship between quadriceps muscle strength and physical function is moderated by the level of knee joint frontal plane laxity. The purpose of the current study is to reexamine the moderation effect of the knee joint laxity as measured by stress radiographs on the relationship between quadriceps muscle strength and physical function. One-hundred and sixty osteoarthritis patients participated in this cross-sectional study. Isometric quadriceps muscle strength was measured using an isokinetic dynamometer. Self-rated and performance-based physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and Get Up and Go test, respectively. Stress radiographs which were taken while applying varus and valgus loads to knee using the TELOS device. Knee joint laxity was determined by measuring the distance between joint surfaces on the medial and lateral sides. Hierarchical multiple regression models were constructed to study the moderation effect of laxity on the strength function relationship. Two regression models were constructed for self-rated and performance-based function. After controlling for demographics, strength contributed significantly in the models. The addition of laxity and laxity-strength interaction did not add significant contributions in the regression models. Frontal plane knee joint laxity measured by stress radiographs does not moderate the relationship between quadriceps muscle strength and physical function in patients with osteoarthritis. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Do Changes in Patellofemoral Joint Offset Lead to Adverse Outcomes in Total Knee Arthroplasty With Patellar Resurfacing? A Radiographic Review.

    PubMed

    Matz, Jacob; Howard, James L; Morden, David J; MacDonald, Steven J; Teeter, Matthew G; Lanting, Brent A

    2017-03-01

    Patellofemoral joint biomechanics contribute to anterior knee pain, instability, and dysfunction following total knee arthroplasty (TKA). Information about specific factors leading to anterior knee pain and dysfunction is currently limited. Changes in patellofemoral joint offset (PFO) refers to a mismatch between the preoperative and postoperative anteroposterior geometry of the patellofemoral joint. It remains unclear whether these changes lead to adverse outcomes in TKA. A retrospective radiographic review of 970 knees pre-TKA and post-TKA was completed to correlate the radiographic and clinical outcomes of changing the PFO using a posterior-stabilized single knee design with patellar resurfacing. A total of 970 patients were reviewed. Postoperatively, the anterior femoral offset, anteroposterior femoral size, and anterior patellar offset were changed in 40%, 60%, and 71% of knees, respectively, compared to preoperative values. The Western Ontario and McMasters Osteoarthritis Index total score as well as subscale scores for pain and function were not significantly affected by an increase or decrease in PFO. Similarly, Knee Society Scores and range of motion were not significantly affected. Increased anterior patellar offset was, however, associated with increased postoperative patellar tilt. Postoperative patellar tilt was not correlated with adverse patient satisfaction scores or loss of range of motion. Changes in PFO (decreased, maintained, or increased) are common post-TKA and are not associated with a difference in clinical outcomes. Increases in anterior patellar offset led to increased patellar tilt, which was not associated with adverse patient satisfaction scores. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Managing Multiplicity: Conceptualizing Physician Cognition in Multipatient Environments.

    PubMed

    Chan, Teresa M; Mercuri, Mathew; Van Dewark, Kenneth; Sherbino, Jonathan; Schwartz, Alan; Norman, Geoff; Lineberry, Matthew

    2018-05-01

    Emergency physicians (EPs) regularly manage multiple patients simultaneously, often making time-sensitive decisions around priorities for multiple patients. Few studies have explored physician cognition in multipatient scenarios. The authors sought to develop a conceptual framework to describe how EPs think in busy, multipatient environments. From July 2014 to May 2015, a qualitative study was conducted at McMaster University, using a think-aloud protocol to examine how 10 attending EPs and 10 junior residents made decisions in multipatient environments. Participants engaged in the think-aloud exercise for five different simulated multipatient scenarios. Transcripts from recorded interviews were analyzed inductively, with an iterative process involving two independent coders, and compared between attendings and residents. The attending EPs and junior residents used similar processes to prioritize patients in these multipatient scenarios. The think-aloud processes demonstrated a similar process used by almost all participants. The cognitive task of patient prioritization consisted of three components: a brief overview of the entire cohort of patients to determine a general strategy; an individual chart review, whereby the participant created a functional patient story from information available in a file (i.e., vitals, brief clinical history); and creation of a relative priority list. Compared with residents, the attendings were better able to construct deeper and more complex patient stories. The authors propose a conceptual framework for how EPs prioritize care for multiple patients in complex environments. This study may be useful to teachers who train physicians to function more efficiently in busy clinical environments.

  17. Popliteal cysts and subgastrocnemius bursitis are associated with knee symptoms and structural abnormalities in older adults: a cross-sectional study.

    PubMed

    Cao, Yuelong; Jones, Graeme; Han, Weiyu; Antony, Benny; Wang, Xia; Cicuttini, Flavia; Ding, Changhai

    2014-03-03

    The role of popliteal cysts and subgastrocnemius bursitis in knee joint homeostasis is uncertain. The aim of this study is to describe cross-sectional associations between popliteal cysts, subgastrocnemius bursitis, knee symptoms and structural abnormalities in older adults. A cross-sectional sample of 900 randomly-selected subjects (mean age 63 years, 48% female) were studied. Knee pain, stiffness and dysfunction were assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic knee osteophyte and joint space narrowing (JSN) were recorded. Magnetic resonance imaging (MRI) was utilized to assess popliteal cysts, subgastrocnemius bursitis, cartilage defects and bone marrow lesions (BMLs). Popliteal cysts were present in 11.7% and subgastrocnemius bursitis in 12.7% of subjects. Subgastrocnemius bursitis was more common in those with popliteal cyst (36.2% versus 9.7%, P <0.01). In multivariable analyses, popliteal cysts were significantly associated with increased osteophytes in both medial and lateral tibiofemoral compartments while subgastrocnemius bursitis was associated with increased osteophytes and JSN in the medial tibiofemoral compartment. Both were significantly associated with cartilage defects in all compartments, and with BMLs in the medial tibiofemoral compartment. Furthermore, both popliteal cysts and subgastrocnemius bursitis were significantly associated with increased weight-bearing knee pain but these associations became non-significant after adjustment for cartilage defects and BMLs. Popliteal cysts and subgastrocnemius bursitis are associated with increased symptoms as well as radiographic and MRI-detected joint structural abnormalities. Longitudinal data will help resolve if they are a consequence or a cause of knee joint abnormalities.

  18. Popliteal cysts and subgastrocnemius bursitis are associated with knee symptoms and structural abnormalities in older adults: a cross-sectional study

    PubMed Central

    2014-01-01

    Introduction The role of popliteal cysts and subgastrocnemius bursitis in knee joint homeostasis is uncertain. The aim of this study is to describe cross-sectional associations between popliteal cysts, subgastrocnemius bursitis, knee symptoms and structural abnormalities in older adults. Methods A cross-sectional sample of 900 randomly-selected subjects (mean age 63 years, 48% female) were studied. Knee pain, stiffness and dysfunction were assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic knee osteophyte and joint space narrowing (JSN) were recorded. Magnetic resonance imaging (MRI) was utilized to assess popliteal cysts, subgastrocnemius bursitis, cartilage defects and bone marrow lesions (BMLs). Results Popliteal cysts were present in 11.7% and subgastrocnemius bursitis in 12.7% of subjects. Subgastrocnemius bursitis was more common in those with popliteal cyst (36.2% versus 9.7%, P <0.01). In multivariable analyses, popliteal cysts were significantly associated with increased osteophytes in both medial and lateral tibiofemoral compartments while subgastrocnemius bursitis was associated with increased osteophytes and JSN in the medial tibiofemoral compartment. Both were significantly associated with cartilage defects in all compartments, and with BMLs in the medial tibiofemoral compartment. Furthermore, both popliteal cysts and subgastrocnemius bursitis were significantly associated with increased weight-bearing knee pain but these associations became non-significant after adjustment for cartilage defects and BMLs. Conclusions Popliteal cysts and subgastrocnemius bursitis are associated with increased symptoms as well as radiographic and MRI-detected joint structural abnormalities. Longitudinal data will help resolve if they are a consequence or a cause of knee joint abnormalities. PMID:24581327

  19. Jumping into the deep-end: results from a pilot impact evaluation of a community-based aquatic exercise program.

    PubMed

    Barker, Anna L; Talevski, Jason; Morello, Renata T; Nolan, Genevieve A; De Silva, Renee D; Briggs, Andrew M

    2016-06-01

    This multi-center quasi-experimental pilot study aimed to evaluate changes in pain, joint stiffness, physical function, and quality of life over 12 weeks in adults with musculoskeletal conditions attending 'Waves' aquatic exercise classes. A total of 109 adults (mean age, 65.2 years; range, 24-93 years) with musculoskeletal conditions were recruited across 18 Australian community aquatic centers. The intervention is a peer-led, 45 min, weekly aquatic exercise class including aerobic, strength, flexibility, and balance exercises (n = 67). The study also included a control group of people not participating in Waves or other formal exercise (n = 42). Outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and EuroQoL five dimensions survey (EQ-5D) at baseline and 12 weeks. Satisfaction with Waves classes was also measured at 12 weeks. Eighty two participants (43 Waves and 39 control) completed the study protocol and were included in the analysis. High levels of satisfaction with classes were reported by Waves participants. Over 90 % of participants reported Waves classes were enjoyable and would recommend classes to others. Waves participants demonstrated improvements in WOMAC and EQ-5D scores however between-group differences did not reach statistical significance. Peer-led aquatic exercise classes appear to improve pain, joint stiffness, physical function and quality of life for people with musculoskeletal conditions. The diverse study sample is likely to have limited the power to detect significant changes in outcomes. Larger studies with an adequate follow-up period are needed to confirm effects.

  20. Improved Function and Reduced Pain after Swimming and Cycling Training in Patients with Osteoarthritis.

    PubMed

    Alkatan, Mohammed; Baker, Jeffrey R; Machin, Daniel R; Park, Wonil; Akkari, Amanda S; Pasha, Evan P; Tanaka, Hirofumi

    2016-03-01

    Arthritis and its associated joint pain act as significant barriers for adults attempting to perform land-based physical activity. Swimming can be an ideal form of exercise for patients with arthritis. Yet there is no information on the efficacy of regular swimming exercise involving patients with arthritis. The effect of a swimming exercise intervention on joint pain, stiffness, and physical function was evaluated in patients with osteoarthritis (OA). Using a randomized study design, 48 sedentary middle-aged and older adults with OA underwent 3 months of either swimming or cycling exercise training. Supervised exercise training was performed for 45 min/day, 3 days/week at 60-70% heart rate reserve for 12 weeks. The Western Ontario and McMaster Universities Arthritis Index was used to measure joint pain, stiffness, and physical limitation. After the exercise interventions, there were significant reductions in joint pain, stiffness, and physical limitation accompanied by increases in quality of life in both groups (all p < 0.05). Functional capacity as assessed by maximal handgrip strength, isokinetic knee extension and flexion power (15-30% increases), and the distance covered in the 6-min walk test increased (all p < 0.05) in both exercise groups. No differences were observed in the magnitude of improvements between swimming and cycling training. Regular swimming exercise reduced joint pain and stiffness associated with OA and improved muscle strength and functional capacity in middle-aged and older adults with OA. Additionally, the benefits of swimming exercise were similar to the more frequently prescribed land-based cycling training. clinicaltrials.gov NCT01836380.

  1. Unsatisfactory Outcome of Arthrodesis Performed After Septic Failure of Revision Total Knee Arthroplasty

    PubMed Central

    Röhner, Eric; Windisch, Christoph; Nuetzmann, Katy; Rau, Max; Arnhold, Michael; Matziolis, Georg

    2015-01-01

    Background: Periprosthetic infection is one of the most dreaded orthopaedic complications. Current treatment procedures include one-stage or two-stage revision total knee arthroplasty. If the periprosthetic infection is no longer controllable after several revision total knee arthroplasties, many surgeons regard knee arthrodesis as a promising option. The aim of our study was to ascertain whether intramedullary nailing results in the suppression or eradication of an infection and to identify risk factors for persistent infection. Methods: All patients who had undergone intramedullary nailing following septic failure of revision total knee arthroplasty between 1997 and 2013 were included in the study. Pathogens, risk factors predisposing to persistent infection, and the rate of persistent infections were recorded. In addition, a visual analog scale (VAS) and Knee injury Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), Lysholm, Short Form-36 (SF-36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires were completed to assess clinical outcomes and quality of life. Results: Twenty-six patients were included in the study. Thirteen (50%) had a persistent infection requiring additional revision surgery. Nineteen patients (73%) reported persistent pain (VAS score of >3). All scores showed marked impairment of quality of life. Conclusions: Intramedullary nailing following septic failure of revision total knee arthroplasty must be regarded with skepticism, and we cannot recommend it. Repeat revision total knee arthroplasty or amputation should be considered as an alternative in such difficult cases. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. PMID:25695981

  2. Physiotherapy program through home visits for community-dwelling elderly Japanese women with mild knee pain.

    PubMed

    Konishi, Isamu; Tanabe, Naohito; Seki, Nao; Suzuki, Hiroshi; Okamura, Taro; Shinoda, Kunihiko; Hoshino, Emiko

    2009-10-01

    Knee pain is extremely common among the elderly, particularly women. Hence, there is an urgent need for applicable community-based intervention models for halting the progression of knee pain and related disabilities in elderly women. We aimed to assess the efficacy of home-visit physiotherapy as a new intervention model. This non-randomized 5-month-long controlled trial enrolled elderly community-dwelling women (aged 60-83 years) with mild knee pain. The intervention consisted of two home visits by a physiotherapist, with instructions on routinely performing muscle-strengthening exercises at home and implementing simple environmental modifications when necessary. Outcome measures were assessed at baseline and 5 months later. The primary outcomes were measured as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a newly devised seiza-style sitting score. People in Japan, especially elderly women, are accustomed to seiza-style sitting that involves kneeling on one's lower legs while resting the buttocks on the heels. The secondary outcomes included quadriceps isometric strength, knee alignment in the frontal and sagittal planes, and passive knee extension range. Forty-two subjects (20 in the intervention group and 22 in the control group) completed the study. At baseline, characteristics and the primary outcomes did not significantly differ between the 2 groups. At 5 months, the primary outcomes improved significantly in the intervention group. Estimated differences in the change from baseline for each outcome between the 2 groups were computed, adjusting for outcome variables imbalanced at baseline. Even after the adjustment, the home-visit physiotherapy regimen provides favorable improvement in the seiza-style sitting score.

  3. Differences in Clinical Pain and Experimental Pain Sensitivity between Asian Americans and Whites with Knee Osteoarthritis

    PubMed Central

    Ahn, Hyochol; Weaver, Michael; Lyon, Debra; Kim, Junglyun; Choi, Eunyoung; Staud, Roland; Fillingim, Roger B.

    2016-01-01

    Objective Ethnicity has been associated with clinical and experimental pain responses. While ethnic disparities in pain in other minority groups compared to whites are well described, pain in Asian Americans remains poorly understood. The purpose of this study was to characterize differences in clinical pain intensity and experimental pain sensitivity among older Asian American and non-Hispanic White (NHW) participants with knee osteoarthritis (OA). Methods Data were collected from 50 Asian Americans ages 45-85 (28 Korean, 9 Chinese, 7 Japanese, 5 Filipino, and 1 Indian) and compared to 50 age- and gender-matched NHW individuals with symptomatic knee OA pain. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Graded Chronic Pain Scale (GCPS) were used to assess the intensity of clinical knee pain. In addition, quantitative sensory testing was used to measure experimental sensitivity to heat- and mechanically-induced pain. Results Asian American participants had significantly higher levels of clinical pain intensity than NHW participants with knee OA. In addition, Asian American participants had significantly higher experimental pain sensitivity than NHW participants with knee OA. Discussion These findings add to the growing literature regarding ethnic and racial differences in clinical pain intensity and experimental pain sensitivity. Asian Americans in particular may be at risk for clinical pain and heightened experimental pain sensitivity. Further investigation is needed to identify the mechanisms underlying ethnic group differences in pain between Asian Americans and non-Hispanic Whites, and to ensure that ethnic group disparities in pain are ameliorated. PMID:28060784

  4. Effect of Mud-Bath Therapy on Serum Biomarkers in Patients with Knee Osteoarthritis: Results from a Randomized Controlled Trial.

    PubMed

    Pascarelli, Nicola A; Cheleschi, Sara; Bacaro, Giovanni; Guidelli, Giacomo M; Galeazzi, Mauro; Fioravanti, Antonella

    2016-01-01

    Balneotherapy is one of the most commonly used non-pharmacological approaches for osteoarthritis (OA). Recent data indicate that some biomarkers could be useful to predict OA progression and to assess therapeutic response. To evaluate the effects of mud-bath therapy on serum biomarkers in patients with knee OA. The study group comprised 103 patients with primary symptomatic bilateral knee OA who were randomly assigned to receive a cycle of mud-bath therapy over a period of 2 weeks or to continue their standard therapy alone. Clinical and biochemical parameters were assessed at baseline and after 2 weeks. Clinical assessments included global pain score on a visual analogue scale (VAS) and the Western Ontario and McMaster Universities Index (WOMAC) subscores for knee OA. Cartilage oligomeric matrix protein (COMP), C-terminal cross-linked telopeptide type II collagen (CTX-II), myeloperoxidase (MPO) and high sensitivity C-reactive protein (hsCRP) serum levels were assessed by ELISA. At the end of mud-bath therapy we observed a statistically significant improvement in VAS and WOMAC subscores. Serum levels of COMP, MPO and hsCRP did not show any significant modification in either group, while a significant increase (P < 0.001) in CTX-II serum levels was observed in the mud-bath group after the treatment. A cycle of mud-bath therapy added to the usual treatment had a beneficial effect on pain and function in patients with knee OA. The evaluation of serum biomarkers showed a significant increase of CTX-II only, perhaps due to an increase of cartilage turnover induced by thermal stress.

  5. A non-invasive biomechanical device and treatment for patients following total hip arthroplasty: results of a 6-month pilot investigation

    PubMed Central

    2013-01-01

    Background The purpose of the study was to examine the effect of a foot-worn biomechanical device on the clinical measurements and gait patterns of patients with total hip arthroplasty (THA). Methods Nineteen patients, up to 3 months post-THA, were enrolled to the study. Patients underwent a computerized gait analysis to calculate spatiotemporal parameters and completed the Western Ontario and McMaster Universities osteoarthritis index and the SF-36 health survey. Patients then began therapy with a non-invasive foot-worn biomechanical device coupled with a treatment methodology (AposTherapy). Patients received exercise guidelines and used the device daily during their regular activities at their own environment. Follow-up examinations were conducted after 4, 12, and 26 weeks of therapy. Repeated measures ANOVA was used to evaluate changes over time. The clinical significance of the treatment effect was evaluated by computing the Cohen's effect sizes (ES statistic). Results After 26 weeks of therapy, a significant improvement was seen in gait velocity (50.3%), involved step length (22.9%), and involved single limb support (16.5%). Additionally, a significant reduction in pain (85.4%) and improvement in function (81.1%) and quality of life (52.1%) were noted. Conclusions Patients following THA demonstrated a significant improvement in gait parameters and in self-assessment evaluations of pain, function, and quality of life. We recommend further RCTs to examine the effect of this therapy compared to other rehabilitation modalities following THA and compared to healthy matched controls. Trial registration Clinical trial registration number NCT01266382 PMID:23692690

  6. The Relationship Between Early-Stage Knee Osteoarthritis and Lower-Extremity Alignment, Joint Laxity, and Subjective Scores of Pain, Stiffness, and Function.

    PubMed

    Hicks-Little, Charlie A; Peindl, Richard D; Hubbard-Turner, Tricia J; Cordova, Mitchell L

    2016-08-01

    Knee osteoarthritis (OA) is a debilitating disease that affects an estimated 27 million Americans. Changes in lower-extremity alignment and joint laxity have been found to redistribute the medial and/or lateral loads at the joint. However, the effect that changes in anteroposterior knee-joint laxity have on lower-extremity alignment and function in individuals with knee OA remains unclear. To examine anteroposterior knee-joint laxity, lower-extremity alignment, and subjective pain, stiffness, and function scores in individuals with early-stage knee OA and matched controls and to determine if a relationship exists among these measures. Case control. Sports-medicine research laboratory. 18 participants with knee OA and 18 healthy matched controls. Participants completed the Western Ontario McMaster (WOMAC) osteoarthritis questionnaire and were tested for total anteroposterior knee-joint laxity (A-P) and knee-joint alignment (ALIGN). WOMAC scores, A-P (mm), and ALIGN (°). A significant multivariate main effect for group (Wilks' Λ = 0.30, F7,26 = 8.58, P < .0001) was found. Knee-OA participants differed in WOMAC scores (P < .0001) but did not differ from healthy controls on ALIGN (P = .49) or total A-P (P = .66). No significant relationships were identified among main outcome measures. These data demonstrate that participants with early-stage knee OA had worse pain, stiffness, and functional outcome scores than the matched controls; however, ALIGN and A-P were no different. There was no association identified among participants' subjective scores, ALIGN, or A-P measures in this study.

  7. Training the next generation of global health advocates through experiential education: A mixed-methods case study evaluation.

    PubMed

    Hoffman, Steven J; Silverberg, Sarah L

    2015-10-15

    This case study evaluates a global health education experience aimed at training the next generation of global health advocates. Demand and interest in global health among Canadian students is well documented, despite the difficulty in integrating meaningful experiences into curricula. Global health advocacy was taught to 19 undergraduate students at McMaster University through an experiential education course, during which they developed a national advocacy campaign on global access to medicines. A quantitative survey and an analysis of social network dynamics were conducted, along with a qualitative analysis of written work and course evaluations. Data were interpreted through a thematic synthesis approach. Themes were identified related to students' learning outcomes, experience and class dynamics. The experiential education format helped students gain authentic, real-world experience in global health advocacy and leadership. The tangible implications for their course work was a key motivating factor. While experiential education is an effective tool for some learning outcomes, it is not suitable for all. As well, group dynamics and evaluation methods affect the learning environment. Real-world global health issues, public health practice and advocacy approaches can be effectively taught through experiential education, alongside skills like communication and professionalism. Students developed a nuanced understanding of many strategies, challenges and barriers that exist in advocating for public health ideas. These experiences are potentially empowering and confidence-building despite the heavy time commitment they require. Attention should be given to how such experiences are designed, as course dynamics and grading structure significantly influence students' experience.

  8. Intestinal helminthic infections among elementary students of Babile town, eastern Ethiopia.

    PubMed

    Tefera, Ephrem; Mohammed, Jemal; Mitiku, Habtamu

    2015-01-01

    Intestinal helminthic infections are important public health problems in developing countries. In Ethiopia, intestinal parasitic infections are highly prevalent because of low living standards and poor environmental sanitation. There are several areas in Ethiopia from which epidemiological information is lacking including Babile town. The aim of this study was to determine the prevalence of intestinal helminthic infection among students of Babile town. A cross sectional study was conducted from May 14 to June 08, 2012. Stool samples collected from 644 students were examined by the McMaster method. Data were analyzed using SPSS version 16.0. Univariate analysis was carried out using the Chi-square test to check for presence or absence of association between exposure and the presence of infection and odds ratios with 95% CI were computed to measure the strength of association. Logistic regression was used to calculate predictors of helminthic infection. Statistical significance was set at P<0.05. The prevalence of intestinal helminths was 13.8%, of which three students were infected with soil transmitted helminths with a prevalence rate of 0.47%. The prevalence of Hymenolepis nana, Enterobius vermicularis, hookworm, and Trichiura trichiura infections were 13, 0.6, 0.3, and 0.2% respectively. Intestinal helminthic infection was significantly associated with grade and sex of the school children. The prevalence of intestinal helminths was low. Health information dissemination is recommended. Since infection by Hymenolepis nana is a long term health problem in the area, provision of regular treatment by anthelminthic drug of choice for hymenolepiasis is also recommended.

  9. Assessment of pulsed electromagnetic field therapy with Serum YKL-40 and ultrasonography in patients with knee osteoarthritis.

    PubMed

    Dündar, Ümit; Aşık, Gülşah; Ulaşlı, Alper Murat; Sınıcı, Şükrü; Yaman, Fatima; Solak, Özlem; Toktaş, Hasan; Eroğlu, Selma

    2016-03-01

    The use of biomarkers of osteoarthritis (OA) have potential for early diagnosis, evaluation of disease severity and monitoring treatment. Serum and synovial fluid YKL-40 levels are increased in severe knee OA. Pulsed electromagnetic field (PEMF) therapy is a novel treatment method for OA. However, studies evaluating the PEMF therapy in treatment of knee OA revealed conflicting results. This study was conducted to objectively assess the effect of PEMF therapy in patients with knee OA, by using ultrasonographic measurements and a novel biomarker, YKL-40. Forty patients were randomized into two treatment groups. Both groups received conventional physical therapy, while Group 1 received additional PEMF therapy. The patients were asked to rate their pain on a visual analogue scale (VAS) and complete a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Serum YKL-40 levels were measured, and knee effusion and cartilage degeneration level were evaluated with ultrasonography before and after treatment. Pre-treatment YKL-40 level was correlated with WOMAC pain subscale (P = 0.032, r = 0.339). VAS and WOMAC scores significantly improved in both treatment groups (P < 0.05). The effusion in the right knee significantly decreased in Group 1. The change in YKL-40 level was not correlated with the change in VAS, WOMAC scores and knee effusion. This study revealed that adjuvant PEMF therapy has no additional effect on pain in patients with knee OA. Serum YKL-40 level seems to be unuseful for monitoring the treatment in knee OA. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  10. Effects of kinesiotherapy, ultrasound and electrotherapy in management of bilateral knee osteoarthritis: prospective clinical trial

    PubMed Central

    2012-01-01

    Background Although recent advances in knee osteoarthritis (OA) treatment and evaluation were achieved, to the best of our knowledge, few studies have evaluated the longitudinal effect of therapeutic modalities on the functional exercise capacity of patients with knee OA. The purpose was to investigate the effects of kinesiotherapy and electrotherapy on functional exercise capacity, evaluated using the six-minute walk test (6-MWT) in patients with bilateral knee OA. Secondary measurements included range of motion (ROM), severity of knee pain (VAS), and a measure of perceived health and physical function, evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Methods A total of 40 women with bilateral knee OA were assigned to three groups: kinesiotherapy (KIN, n = 16), transcutaneous electrical nerve stimulation (TENS, n = 12), or ultrasound (US, n = 10). The groups underwent 12 weeks of intervention twice per week. The participants were subjected to the 6-MWT, ROM, VAS and WOMAC index. These tests were performed before and after the intervention. The study was focused on outpatients and was carried out at Universidade Estadual de Campinas, Brazil. Results At follow-up, the KIN and US groups had significantly higher 6-MWT distances (19.8 ± 21.7 and 14.1 ± 22.5%, respectively) compared with their respective pre-intervention values. All treatments were effective for reducing pain and improving the WOMAC index. Conclusions We demonstrated that the 6-MWT is a tool that can be used to evaluate improvements in the functional exercise capacity of patients submitted to a clinical intervention. PMID:22999098

  11. Effects of kinesiotherapy, ultrasound and electrotherapy in management of bilateral knee osteoarthritis: prospective clinical trial.

    PubMed

    Mascarin, Naryana Cristina; Vancini, Rodrigo Luiz; Andrade, Marã Lia Dos Santos; Magalhães, Eduardo de Paiva; de Lira, Claudio Andre Barbosa; Coimbra, Ibsen Bellini

    2012-09-22

    Although recent advances in knee osteoarthritis (OA) treatment and evaluation were achieved, to the best of our knowledge, few studies have evaluated the longitudinal effect of therapeutic modalities on the functional exercise capacity of patients with knee OA. The purpose was to investigate the effects of kinesiotherapy and electrotherapy on functional exercise capacity, evaluated using the six-minute walk test (6-MWT) in patients with bilateral knee OA. Secondary measurements included range of motion (ROM), severity of knee pain (VAS), and a measure of perceived health and physical function, evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. A total of 40 women with bilateral knee OA were assigned to three groups: kinesiotherapy (KIN, n = 16), transcutaneous electrical nerve stimulation (TENS, n = 12), or ultrasound (US, n = 10). The groups underwent 12 weeks of intervention twice per week. The participants were subjected to the 6-MWT, ROM, VAS and WOMAC index. These tests were performed before and after the intervention. The study was focused on outpatients and was carried out at Universidade Estadual de Campinas, Brazil. At follow-up, the KIN and US groups had significantly higher 6-MWT distances (19.8 ± 21.7 and 14.1 ± 22.5%, respectively) compared with their respective pre-intervention values. All treatments were effective for reducing pain and improving the WOMAC index. We demonstrated that the 6-MWT is a tool that can be used to evaluate improvements in the functional exercise capacity of patients submitted to a clinical intervention.

  12. A systematic review of self-administered questionnaires for the functional assessment of patients with knee disabilities adapted into Spanish.

    PubMed

    Gómez-Valero, S; García-Pérez, F; Flórez-García, M T; Miangolarra-Page, J C

    The aim of this study was to conduct a systematic review of self-administered knee-disability functional assessment questionnaires adapted to Spanish, analysing the quality of the transcultural adaptation procedure and the psychometric properties of the new version. A search was conducted in the main biomedical databases to find knee-function assessment scales adapted into Spanish, in order to assess their questionnaire adaptation process as well as their psychometric properties. Ten scales were identified; 3 for lower limb: 2 for any type of pathologies (Lower Limb Functional Index [LLFI]; Lower Extremity Functional Scale [LEFS]) and 1 specific for arthrosis (Arthrosis des Membres Inférieurs et Qualité de vie [AMICAL]); Other 3 for knee and hip pathologies (Western Ontario and McMaster Universities Osteoarthritis [WOMAC] index; Osteoarthritis Knee and Hip Quality of Life [OAKHQOL] questionnaire; Hip and Knee Questionnaire [HKQ]), and other 4 for knee: 2 general scales (Knee Injury and Osteoarthritis Outcome Score [KOOS]; Knee Society Clinical Rating System [KSS]) and 2 specifics (Victorian Institute of Sport Assessment [VISA-P] questionnaire for patients with patellar tendinopathy and Kujala Score for patellofemoral pain). The transcultural adaptation procedure was satisfactory, albeit somewhat less rigorous for HKQ and LLFI. In no study were all psychometric properties assessed. Reliability was analyzed in all cases, except in KSS. Validity was measured in all questionnaires. The transcultural adaptation procedure was satisfactory and the psychometric properties analysed were similar to both the original version and other versions adapted to other languages. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. A Systematic Review of Measurement Properties of Patient-Reported Outcome Measures Used in Patients Undergoing Total Knee Arthroplasty.

    PubMed

    Gagnier, Joel J; Mullins, Megan; Huang, Hsiaomin; Marinac-Dabic, Danica; Ghambaryan, Anna; Eloff, Benjamin; Mirza, Faisal; Bayona, Manuel

    2017-05-01

    While clinical research on total knee arthroplasty (TKA) outcomes is prevalent in the literature, studies often have poor methodological and reporting quality. A high-quality patient-reported outcome instrument is reliable, valid, and responsive. Many studies evaluate these properties, but none have done so with a systematic and accepted method. The objectives of this study were to identify patient-reported outcome measures (PROMs) for TKA, and to critically appraise, compare, and summarize their psychometric properties using accepted methods. MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO, and SPORTDiscus were systematically searched for articles with the following inclusion criteria: publication before December 2014, English language, non-generic PRO, and evaluation in the TKA population. Methodological quality and evidence of psychometric properties were assessed with the COnsensus-based standards for the selection of health Status Measurement INstruments (COSMIN) checklist and criteria for psychometric evidence proposed by the COSMIN group and Terwee et al. One-hundred fifteen studies on 32 PROMs were included in this review. Only the Work, Osteoarthritis or joint-Replacement Questionnaire, the Oxford Knee Score, and the Western Ontario and McMaster Universities Arthritis Index had 4 or more properties with positive evidence. Most TKA PROMs have limited evidence for their psychometric properties. Although not all the properties were studied, the Work, Osteoarthritis or joint-Replacement Questionnaire, with the highest overall ratings, could be a useful PROM for evaluating patients undergoing TKA. The methods and reporting of this literature can improve by following accepted guidelines. Published by Elsevier Inc.

  14. MiR-300 Serves as Potential Biomarker to Screen Knee Osteoarthritis Patients by Targeting TNFα.

    PubMed

    Zhou, Zihao; Tian, Fengde; An, Ning; Zhang, Yao; Wang, Changcheng; Guo, Lin

    2018-04-01

    This study mainly explored the serum level of miR-300 with the risk of knee OA, thereby evaluating their diagnostic ability for treatment of knee osteoarthritis (KOA) patients. In the current study, we evaluated the level of TNFα in KOA patients and HCs. The serum was used to quantify the level of TNF-α by way of a sandwich enzyme-linked immunosorbent assay. Dual luciferase reporter assay was carried out to identify the possible target gene of miR-300. In line with previous studies, our data showed that serum TNFα level was increased along with K/L grades and WOMAC scoring, suggesting TNFα induced inflammatory responses correlating with the severity of KOA. We also showed that serum miR-300 level was increased with the severity of KOA according to X ray examination and K/L grades. Furthermore, we showed that serum miR-300 level positively correlated with K/L grades, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scoring and WOMAC function scoring. Bioinformatic predictions showed a conserved binding site of miR-300 in the 3'UTR of IκBα. We then carried out a dual luciferase reporter assay and found miR-300 significantly suppressed pmirGLO-IκBα-3'UTR luciferase activity. Serum miR-300 is increased with the severity of KOA according to X-ray examination and K/L grades, thereby reflecting the severity of KOA and the degree of cartilage damage. Therefore, it could be used as a potential biomarker to screen KOA patients from healthy controls.

  15. User experience of transtibial prosthetic liners: A systematic review.

    PubMed

    Richardson, Amy; Dillon, Michael P

    2017-02-01

    The liner is an integral part of a transtibial prosthesis designed to protect the residual limb, enhance comfort and provide suspension. Literature is difficult to interpret and use given the variety of interventions, outcome measures and method designs. Critical appraisal and synthesis of the evidence is needed to help inform decisions about liner prescription based on the user experience. To critically appraise and synthesise research describing the user experience of transtibial prosthetic liners. Systematic review. A comprehensive suite of databases were searched using terms related to amputation level, liner type and user experience. Included studies were in English and measured the first-person experience of using a transtibial liner. Studies were appraised using the McMaster University Critical Review Forms. A total of 18 articles met the inclusion criteria. While the quality of the evidence has improved over time, a number of common issues (e.g. sampling bias, validity of outcome measures, incorrect inferential analysis) reduce our ability to differentiate between the user experience of different transtibial liners. There is insufficient research to differentiate between the user experience of different transtibial liners. High-quality research is needed to inform decisions about liner prescription based on the user experience. Clinical relevance The available evidence suggests that the user experience of commonly reported problems (e.g. sweating) may be very similar between different liners. Aspects of the user experience that differ most between liners (e.g. unwanted noises, rotation within the socket) can help focus attention on what matters most when discussing prescription.

  16. Flavocoxid is as effective as naproxen for managing the signs and symptoms of osteoarthritis of the knee in humans: a short-term randomized, double-blind pilot study.

    PubMed

    Levy, Robert M; Saikovsky, Roman; Shmidt, Evgeniya; Khokhlov, Alexander; Burnett, Bruce P

    2009-05-01

    Flavocoxid (Limbrel), a proprietary mixture of flavonoid molecules (baicalin and catechin), was tested against a traditional nonsteroidal anti-inflammatory drug, naproxen, for the management of the signs and symptoms of moderate osteoarthritis (OA) in humans. Discomfort and global disease activity were used as the primary end points, and safety assessments were also taken for both treatments as a secondary endpoint. In this double-blind study, 103 subjects were randomly assigned to receive either flavocoxid [500 mg twice daily (BID)] or naproxen (500 mg BID) in a 1-month onset of action trial. Outcome measures included the short Western Ontario and McMaster University Osteoarthritis Index, subject Visual Analogue Scale for discomfort and global response, and investigator Visual Analogue Scale for global response and fecal occult blood. Both flavocoxid and naproxen showed significant reduction in the signs and symptoms of knee OA (P < or = .001). There were no statistically detectable differences between the flavocoxid and naproxen groups with respect to any of the outcome variables. Similarly, there were no statistically detectable differences between the groups with respect to any adverse event, although there was a trend toward a higher incidence of edema and nonspecific musculoskeletal discomfort in the naproxen group. In this short-term pilot study, flavocoxid was as effective as naproxen in controlling the signs and symptoms of OA of the knee and would present a safe and effective option for those individuals on traditional nonsteroidal anti-inflammatory drugs or cyclooxygenase-2 inhibitors. A low incidence of adverse events was reported for both groups.

  17. Efficacy of a multimodal physiotherapy treatment program for hip osteoarthritis: a randomised placebo-controlled trial protocol.

    PubMed

    Bennell, Kim L; Egerton, Thorlene; Pua, Yong-Hao; Abbott, J Haxby; Sims, Kevin; Metcalf, Ben; McManus, Fiona; Wrigley, Tim V; Forbes, Andrew; Harris, Anthony; Buchbinder, Rachelle

    2010-10-14

    Hip osteoarthritis (OA) is a common condition leading to pain, disability and reduced quality of life. There is currently limited evidence to support the use of conservative, non-pharmacological treatments for hip OA. Exercise and manual therapy have both shown promise and are typically used together by physiotherapists to manage painful hip OA. The aim of this randomised controlled trial is to compare the efficacy of a physiotherapy treatment program with placebo treatment in reducing pain and improving physical function. The trial will be conducted at the University of Melbourne Centre for Health, Exercise and Sports Medicine. 128 participants with hip pain greater or equal to 40/100 on visual analogue scale (VAS) and evidence of OA on x-ray will be recruited. Treatment will be provided by eight community physiotherapists in the Melbourne metropolitan region. The active physiotherapy treatment will comprise a semi-structured program of manual therapy and exercise plus education and advice. The placebo treatment will consist of sham ultrasound and the application of non-therapeutic gel. The participants and the study assessor will be blinded to the treatment allocation. Primary outcomes will be pain measured by VAS and physical function recorded on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) immediately after the 12 week intervention. Participants will also be followed up at 36 weeks post baseline. The trial design has important strengths of reproducibility and reflecting contemporary physiotherapy practice. The findings from this randomised trial will provide evidence for the efficacy of a physiotherapy program for painful hip OA.

  18. Racial differences in knee osteoarthritis pain: potential contribution of occupational and household tasks.

    PubMed

    Allen, Kelli D; Chen, Jiu-Chiuan; Callahan, Leigh F; Golightly, Yvonne M; Helmick, Charles G; Renner, Jordan B; Schwartz, Todd A; Jordan, Joanne M

    2012-02-01

    We examined whether occupational and household tasks contributed to differences in pain between African Americans and whites with radiographic knee osteoarthritis (OA). Participants from the Johnston County Osteoarthritis Project self-reported the frequency (often/always vs never/seldom/sometimes) of performing 9 occupational tasks involving lower extremity joint loading at their longest job (N = 868) and current job (N = 273), as well as 8 household tasks ever performed (N = 811) and currently being performed (N = 767). The associations of the numbers of occupational or household tasks with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale were first examined in simple linear regression models. If significantly associated with greater pain, each of these was included in adjusted linear regression models to examine whether the association of race with pain remained statistically significant. African Americans reported significantly greater WOMAC pain scores than whites. Exposures to more occupational tasks at the longest job and the current job were associated with greater WOMAC pain scores (p < 0.01). The association of race with greater pain scores remained statistically significant when controlling for occupational tasks at the longest job, but was reduced by 26% and no longer significant when controlling for the number of current occupational tasks. Exposures to an increasing number of household tasks were associated with lower pain scores and were not further analyzed. Current performance of physically demanding occupational tasks contributed to racial differences in pain severity among individuals with knee OA. Better workplace policies to accommodate OA-related limitations may help to reduce racial differences in pain.

  19. Family Physician attitudes about prescribing using a drug formulary

    PubMed Central

    Suggs, L Suzanne; Raina, Parminder; Gafni, Amiram; Grant, Susan; Skilton, Kevin; Fan, Aimei; Szala-Meneok, Karen

    2009-01-01

    Background Drug formularies have been created by third party payers to control prescription drug usage and manage costs. Physicians try to provide the best care for their patients. This research examines family physicians' attitudes regarding prescription reimbursement criteria, prescribing and advocacy for patients experiencing reimbursement barriers. Methods Focus groups were used to collect qualitative data on family physicians' prescribing decisions related to drug reimbursement guidelines. Forty-eight family physicians from four Ontario cities participated. Ethics approval for this study was received from the Hamilton Health Sciences/Faculty of Health Sciences Research Ethics Board at McMaster University. Four clinical scenarios were used to situate and initiate focus group discussions about prescribing decisions. Open-ended questions were used to probe physicians' experiences and attitudes and responses were audio recorded. NVivo software was used to assist in data analysis. Results Most physicians reported that drug reimbursement guidelines complicated their prescribing process and can require lengthy interpretation and advocacy for patients who require medication that is subject to reimbursement restrictions. Conclusion Physicians do not generally see their role as being cost-containment monitors and observed that cumbersome reimbursement guidelines influence medication choice beyond the clinical needs of the patient, and produce unequal access to medication. They observed that frustration, discouragement, fatigue, and lack of appreciation can often contribute to family physicians' failure to advocate more for patients. Physicians argue cumbersome reimbursement regulations contribute to lower quality care and misuse of physicians' time increasing overall health care costs by adding unnecessary visits to family physicians, specialists, and emergency rooms. PMID:19835601

  20. Patient-reported outcome measures in arthroplasty registries

    PubMed Central

    Eresian Chenok, Kate; Bohm, Eric; Lübbeke, Anne; Denissen, Geke; Dunn, Jennifer; Lyman, Stephen; Franklin, Patricia; Dunbar, Michael; Overgaard, Søren; Garellick, Göran; Dawson, Jill

    2016-01-01

    The International Society of Arthroplasty Registries (ISAR) Steering Committee established the Patient-Reported Outcome Measures (PROMs) Working Group to convene, evaluate, and advise on best practices in the selection, administration, and interpretation of PROMs and to support the adoption and use of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions. The establishment of a PROM instrument requires the fulfillment of methodological standards and rigorous testing to ensure that it is valid, reliable, responsive, and acceptable to the intended population. A survey of the 41 ISAR member registries showed that 8 registries administered a PROMs program that covered all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the University of California at Los Angeles Activity Score (UCLA). PMID:27168175

  1. Reliability and Validity of the Sensory Component of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI): A Systematic Review.

    PubMed

    Hales, M; Biros, E; Reznik, J E

    2015-01-01

    Since 1982, the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) has been used to classify sensation of spinal cord injury (SCI) through pinprick and light touch scores. The absence of proprioception, pain, and temperature within this scale creates questions about its validity and accuracy. To assess whether the sensory component of the ISNCSCI represents a reliable and valid measure of classification of SCI. A systematic review of studies examining the reliability and validity of the sensory component of the ISNCSCI published between 1982 and February 2013 was conducted. The electronic databases MEDLINE via Ovid, CINAHL, PEDro, and Scopus were searched for relevant articles. A secondary search of reference lists was also completed. Chosen articles were assessed according to the Oxford Centre for Evidence-Based Medicine hierarchy of evidence and critically appraised using the McMasters Critical Review Form. A statistical analysis was conducted to investigate the variability of the results given by reliability studies. Twelve studies were identified: 9 reviewed reliability and 3 reviewed validity. All studies demonstrated low levels of evidence and moderate critical appraisal scores. The majority of the articles (~67%; 6/9) assessing the reliability suggested that training was positively associated with better posttest results. The results of the 3 studies that assessed the validity of the ISNCSCI scale were confounding. Due to the low to moderate quality of the current literature, the sensory component of the ISNCSCI requires further revision and investigation if it is to be a useful tool in clinical trials.

  2. Comparative effects of proprioceptive and isometric exercises on pain intensity and difficulty in patients with knee osteoarthritis: A randomised control study.

    PubMed

    Ojoawo, Adesola O; Olaogun, Matthew O B; Hassan, Mariam A

    2016-11-14

    The study compared the effects of isometric quadriceps exercise and proprioceptive exercise on pain, joint stiffness and physical difficulties of patients with knee osteoarthritis. Forty-five patients with history of knee osteoarthritis were randomly allocated into two groups; A with 23 subjects and B with 22 subjects. All subjects received infrared radiation for 20 minutes and kneading massage with methyl salicylate ointment. Group A underwent proprioceptive exercises while Group B had isometric quadriceps exercise. Each exercise session lasted for 10 minutes according to standard protocol, twice in a week for six weeks. Pre-treatment, 3rd week and 6th week pain intensity, joint stiffness and physical difficulties were assessed using Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Statistical package for social sciences (SPSS) version 17 was used to analyse the data while descriptive and inferential statistics were used to summarise the result. Proprioceptive exercises reduced pain intensity significantly (F = 4.76; p = 0.00) at 6th week with effect size of 2.79, and physical difficulty (F = 3.69; p < 0.04) with effect size of 7.53 better than isometric exercises. There was a significant reduction in the pain intensity (F = 12.08; p < 0.001), and physical difficulties (F = 3.69, p = 0.04) in pre-treatment, 3rd week and 6th week in both Group A and B. Both exercises are effective but proprioceptive exercises may be more effective in the management of patients with knee osteoarthritis (KOA) than isometric exercises.

  3. An Autologous Anti-Inflammatory Protein Solution Yielded a Favorable Safety Profile and Significant Pain Relief in an Open-Label Pilot Study of Patients with Osteoarthritis

    PubMed Central

    Hix, Jason; Klaassen, Mark; Foreman, Ryan; Cullen, Edith; Toler, Krista; King, William; Woodell-May, Jennifer

    2017-01-01

    Abstract Osteoarthritis (OA) is a progressive and degenerative disease, which may result in significant pain and decreased quality of life. Recent updates in our understanding of OA have demonstrated that it is a whole joint disease that has many similarities to an unhealed wound containing inflammatory cytokines. The nSTRIDE Autologous Protein Solution (APS) Kit is a medical device under development for the treatment of OA. The APS Kit processes a patient's own blood at the point of care to contain high concentrations of anti-inflammatory cytokines and anabolic growth factors. This study assessed the safety and treatment effects of a single intra-articular injection of APS. Eleven patients were enrolled in this study. Sufficient blood could not be drawn from one patient who was subsequently withdrawn, leaving 10 patients treated. Minor adverse events (AEs) were experienced by seven subjects (63.6%). There was one serious AE (diverticulitis) unrelated to the device or procedure. One subject experienced AEs that were judged “likely” to be procedure related (arthralgia/musculoskeletal discomfort) and all resolved within 6 days of injection. All other AEs were unrelated to the device or procedure. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores improved significantly over time (ANOVA, p < 0.0001, 12.0 ± 1.2 preinjection, 3.3 ± 2.9 one year postinjection, and 72.5% WOMAC pain improvement). There was significant positive correlation between white blood cell concentration in APS and improvement in WOMAC pain scores. PMID:29279807

  4. A Reduced Duty Hours Model for Senior Internal Medicine Residents: A Qualitative Analysis of Residents' Experiences and Perceptions.

    PubMed

    Mathew, Rebecca; Gundy, Serena; Ulic, Diana; Haider, Shariq; Wasi, Parveen

    2016-09-01

    To assess senior internal medicine residents' experience of the implementation of a reduced duty hours model with night float, the transition from the prior 26-hour call system, and the new model's effects on resident quality of life and perceived patient safety in the emergency department and clinical teaching unit at McMaster University. Qualitative data were collected during May 2013-July 2014, through resident focus groups held prior to implementation of a reduced duty hours model and 10 to 12 months postimplementation. Data analysis was guided by a constructivist grounded theory based in a relativist paradigm. Transcripts were coded; codes were collapsed into themes. Thematic analysis revealed five themes. Residents described reduced fatigue in the early morning, counterbalanced with worsened long-term fatigue on night float blocks; anticipation of negative impacts of the loss of distributed on-call experience and on-call shift volume; an urgency to sleep postcall in anticipation of consecutive night float shifts accompanied by conflicting role demands to stay postcall for care continuity; increased handover frequency accompanied by inaccurate/incomplete communication of patients' issues; and improvement in the senior resident experience on the clinical teaching unit, with increased ownership over patient care and improved relationships with junior housestaff. A reduced duty hours model with night float has potential to improve residents' perceived fatigue on call and care continuity on the clinical teaching unit. This must be weighed against increased handover frequency and loss of the postcall day, which may negatively affect patient care and resident quality of life.

  5. Therapeutic efficacy of different brands of albendazole against soil transmitted helminths among students of Mendera Elementary School, Jimma, Southwest Ethiopia

    PubMed Central

    Tefera, Ephrem; Belay, Tariku; Mekonnen, Seleshi Kebede; Zeynudin, Ahmed; Belachew, Tefera

    2015-01-01

    Introduction Different brands Albendazole are commercially available and the efficacious brand/s is/are required for effective control of STHs infection. Thus, this study is aimed at determining the therapeutic efficacy of different brands of albendazole against soil transmitted helminths among school children of Jimma town. Methods A cross sectional survey for prevalence of geohelminths and a randomized trial for efficacy study of different brands of albendazole was conducted among students Mendera Elementary School from March 29 to April 29, 2010. Positive subjects were randomized into three treatment arms using lottery method. The collected stool samples were examined by the McMaster method. CRs were calculated using SPSS windows version 16 and ERRs were calculated using appropriate formula. Results Of the 715 school children who had their stools examined, 326 were positive for STHs with a prevalence rate of 45.6%. The cure rates (CR) for A. lumbricoides, T. trichiura and Hookworm were 99.4, 59.9 and 93.7%, respectively. Similarly, the egg reduction rates (ERR) were 97, 99.9 and 99.9% respectively. A statistical significant mean STH egg count difference were observed between pre and post-intervention study (p <0.001). But no statistical significant curing effect difference were observed among the three brands used against the three STHs (p >0.05). Conclusion All the three brands of Albendazole tested regardless of the brand type were therapeutically efficacious for Ascariasis, Trichuriasis and Hookworm infections irrespective of the infection status whether it was single or multiple. PMID:26958115

  6. Efficacy of Direct Injection of Etanercept into Knee Joints for Pain in Moderate and Severe Knee Osteoarthritis

    PubMed Central

    Orita, Sumihisa; Yamauchi, Kazuyo; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Kuniyoshi, Kazuki; Aoki, Yasuchika; Nakamura, Junichi; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Kamoda, Hiroto; Suzuki, Miyako; Kubota, Gou; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Shiga, Yasuhiro; Abe, Koki; Fujimoto, Kazuki; Kanamoto, Hiroto; Toyone, Tomoaki; Inoue, Gen; Takahashi, Kazuhisa

    2015-01-01

    Purpose Osteoarthritic (OA) pain is largely considered to be inflammatory pain. However, during the last stage of knee OA, sensory nerve fibers in the knee are shown to be significantly damaged when the subchondral bone junction is destroyed, and this can induce neuropathic pain. Several authors have reported that tumor necrosis factor-α (TNFα) in a knee joint plays a crucial role in pain modulation. The purpose of the current study was to evaluate the efficacy of etanercept, a TNFα inhibitor, for pain in knee OA. Materials and Methods Thirty-nine patients with knee OA and a 2-4 Kellgren-Lawrence grading were evaluated in this prospective study. Patients were divided into two groups; hyaluronic acid (HA) and etanercept injection. All patients received a single injection into the knee. Pain scores were evaluated before and 4 weeks after injection using a visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and they were compared between the groups. Results Before injection, VAS and WOMAC scores were not significantly different between the groups (p>0.05). Significant pain relief was found in the etanercept group at 1 and 2 weeks by VAS, and at 4 weeks by WOMAC score, compared with the HA group (p<0.05). No adverse events were observed in either group. Conclusion Direct injection of etanercept into OA knee joints was an effective treatment for pain in moderate and severe OA patients. Furthermore, this finding suggests that TNFα is one factor that induces OA pain. PMID:26256983

  7. Reliability and Validity of the Sensory Component of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI): A Systematic Review

    PubMed Central

    Hales, M.; Biros, E.

    2015-01-01

    Background: Since 1982, the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) has been used to classify sensation of spinal cord injury (SCI) through pinprick and light touch scores. The absence of proprioception, pain, and temperature within this scale creates questions about its validity and accuracy. Objectives: To assess whether the sensory component of the ISNCSCI represents a reliable and valid measure of classification of SCI. Methods: A systematic review of studies examining the reliability and validity of the sensory component of the ISNCSCI published between 1982 and February 2013 was conducted. The electronic databases MEDLINE via Ovid, CINAHL, PEDro, and Scopus were searched for relevant articles. A secondary search of reference lists was also completed. Chosen articles were assessed according to the Oxford Centre for Evidence-Based Medicine hierarchy of evidence and critically appraised using the McMasters Critical Review Form. A statistical analysis was conducted to investigate the variability of the results given by reliability studies. Results: Twelve studies were identified: 9 reviewed reliability and 3 reviewed validity. All studies demonstrated low levels of evidence and moderate critical appraisal scores. The majority of the articles (~67%; 6/9) assessing the reliability suggested that training was positively associated with better posttest results. The results of the 3 studies that assessed the validity of the ISNCSCI scale were confounding. Conclusions: Due to the low to moderate quality of the current literature, the sensory component of the ISNCSCI requires further revision and investigation if it is to be a useful tool in clinical trials. PMID:26363591

  8. Impact of Balance Confidence on Daily Living Activities of Older People with Knee Osteoarthritis with Regard to Balance, Physical Function, Pain, and Quality of Life - A Preliminary Report.

    PubMed

    Bobić Lucić, Lana; Grazio, Simeon

    2018-01-01

    The objective of this study was to explore the impact of balance confidence on different activities of daily living (ADL) in older people with knee osteoarthritis (OA). Forty-seven consecutive participants with knee OA were included in this cross-sectional study. They were divided according to the results of the Activities-specific Balance Confidence (ABC) Scale into a group with a low level of confidence in physical functioning (ABC < 50, n = 22) and a group with moderate and high levels of confidence (ABC ≥ 50, n = 25). In the ABC < 50 group, the effect of pain on ADL, the physician's global assessment of the disease, and the Western Ontario and McMaster Universities Osteoarthritis Index scores were significantly higher, while quality of life (Short form-36) was lower compared to the ABC ≥ 50 group. No significant difference was found between the two groups regarding the static and dynamic balance measurements. Older people with knee OA who were less confident in their daily physical activities had more physical difficulties and a greater effect of pain on ADL, lower quality of life, and a higher physician's global assessment, but no differences were obtained in balance tests. In people with knee OA, decreased balance confidence is associated with more physical difficulties, an increased effect of pain on ADL, and lower quality of life. An improved awareness of decreased balance confidence may lead to more effective management of older people with knee OA by improving their mobility and QOL through rehabilitation. Furthermore, future research in that direction is warranted.

  9. Manual physical therapy and perturbation exercises in knee osteoarthritis.

    PubMed

    Rhon, Daniel; Deyle, Gail; Gill, Norman; Rendeiro, Daniel

    2013-11-01

    Knee osteoarthritis (OA) causes disability among the elderly and is often associated with impaired balance and proprioception. Perturbation exercises may help improve these impairments. Although manual physical therapy is generally a well-tolerated treatment for knee OA, perturbation exercises have not been evaluated when used with a manual physical therapy approach. The purpose of this study was to observe tolerance to perturbation exercises and the effect of a manual physical therapy approach with perturbation exercises on patients with knee OA. This was a prospective observational cohort study of 15 patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), global rating of change (GROC), and 72-hour post-treatment tolerance were primary outcome measures. Patients received perturbation balance exercises along with a manual physical therapy approach, twice weekly for 4 weeks. Follow-up evaluation was done at 1, 3, and 6 months after beginning the program. Mean total WOMAC score significantly improved (P = 0.001) after the 4-week program (total WOMAC: initial, 105; 4 weeks, 56; 3 months, 54; 6 months, 57). Mean improvements were similar to previously published trials of manual physical therapy without perturbation exercises. The GROC score showed a minimal clinically important difference (MCID)≥+3 in 13 patients (87%) at 4 weeks, 12 patients (80%) at 3 months, and 9 patients (60%) at 6 months. No patients reported exacerbation of symptoms within 72 hours following each treatment session. A manual physical therapy approach that also included perturbation exercises was well tolerated and resulted in improved outcome scores in patients with knee OA.

  10. Cross-Cultural adaptation of the General Functioning Scale of the Family

    PubMed Central

    Pires, Thiago; de Assis, Simone Gonçalves; Avanci, Joviana Quintes; Pesce, Renata Pires

    2016-01-01

    ABSTRACT OBJECTIVE To describe the process of cross-cultural adaptation of the General Functioning Scale of the Family, a subscale of the McMaster Family Assessment Device, for the Brazilian population. METHODS The General Functioning Scale of the Family was translated into Portuguese and administered to 500 guardians of children in the second grade of elementary school in public schools of Sao Gonçalo, Rio de Janeiro, Southeastern Brazil. The types of equivalences investigated were: conceptual and of items, semantic, operational, and measurement. The study involved discussions with experts, translations and back-translations of the instrument, and psychometric assessment. Reliability and validity studies were carried out by internal consistency testing (Cronbach’s alpha), Guttman split-half correlation model, Pearson correlation coefficient, and confirmatory factor analysis. Associations between General Functioning of the Family and variables theoretically associated with the theme (father’s or mother’s drunkenness and violence between parents) were estimated by odds ratio. RESULTS Semantic equivalence was between 90.0% and 100%. Cronbach’s alpha ranged from 0.79 to 0.81, indicating good internal consistency of the instrument. Pearson correlation coefficient ranged between 0.303 and 0.549. Statistical association was found between the general functioning of the family score and the theoretically related variables, as well as good fit quality of the confirmatory analysis model. CONCLUSIONS The results indicate the feasibility of administering the instrument to the Brazilian population, as it is easy to understand and a good measurement of the construct of interest. PMID:27355464

  11. Leadership training in a family medicine residency program: Cross-sectional quantitative survey to inform curriculum development.

    PubMed

    Gallagher, Erin; Moore, Ainsley; Schabort, Inge

    2017-03-01

    To assess the current status of leadership training as perceived by family medicine residents to inform the development of a formal leadership curriculum. Cross-sectional quantitative survey. Department of Family Medicine at McMaster University in Hamilton, Ont, in December 2013. A total of 152 first- and second-year family medicine residents. Family medicine residents' attitudes toward leadership, perceived level of training in various leadership domains, and identified opportunities for leadership training. Overall, 80% (152 of 190) of residents completed the survey. On a Likert scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree), residents rated the importance of physician leadership in the clinical setting as high (6.23 of 7), whereas agreement with the statement "I am a leader" received the lowest rating (5.28 of 7). At least 50% of residents desired more training in the leadership domains of personal mastery, mentorship and coaching, conflict resolution, teaching, effective teamwork, administration, ideals of a healthy workplace, coalitions, and system transformation. At least 50% of residents identified behavioural sciences seminars, a lecture and workshop series, and a retreat as opportunities to expand leadership training. The concept of family physicians as leaders resonated highly with residents. Residents desired more personal and system-level leadership training. They also identified ways that leadership training could be expanded in the current curriculum and developed in other areas. The information gained from this survey might facilitate leadership development among residents through application of its results in a formal leadership curriculum. Copyright© the College of Family Physicians of Canada.

  12. Navigation-assisted versus conventional total knee replacement: no difference in patient-reported outcome measures (PROMs) at 1 and 2 years.

    PubMed

    Singisetti, Kiran; Muthumayandi, Karthikeyan; Abual-Rub, Zaid; Weir, David

    2015-11-01

    Navigation technique for total knee replacement has been shown to improve accuracy of prosthesis alignment in several studies. The purpose was to compare the patient-reported outcome measures in primary total knee replacement (TKR) using navigation versus conventional surgical technique at 1- and 2-year follow-up. A retrospective review of prospectively collected patient-reported outcome data for 351 consecutively performed primary TKR was included in the study. The study group (N = 113) included patients who had Triathlon TKR using articular surface mounted (ASM Stryker) navigation technique and control group (N = 238) included patients who had Triathlon TKR using conventional jig. In addition to the WOMAC (Western Ontario and McMaster University Osteoarthritis Index) and SF-36 (Medical Outcomes Trust Short Form-36), a short self-report questionnaire evaluating the level of satisfaction, quality of life and whether patients would undergo knee replacement again. WOMAC: no significant difference between the groups was noted in mean WOMAC pain, function and stiffness scores at 1- and 2-year follow-up. SF-36: no significant difference between the groups was seen except in the physical function component of score at 1 year (p = 0.019). Navigation group mean 56.78 (CI 51.06-62.5) versus conventional group mean 48.34 (44.68-52.01) but this difference was not observed at 2-year follow-up. The overall patient-reported outcome scores improved after total knee replacement but appear to be comparable in both groups at 1- and 2-year follow-up.

  13. Complementary and alternative medicine utilisation for the management of acute respiratory tract infection in children: A systematic review.

    PubMed

    Lucas, S; Leach, M; Kumar, S

    2018-04-01

    As many as one in two children across the globe use complementary and alternative medicine (CAM) to manage a health condition. Despite the high prevalence of use, there is still limited information on the types of CAM used in children, particularly for the management of one of the most common childhood health complaints - acute respiratory tract infection (ARTI). This systematic review was undertaken to address this knowledge gap. Eligible studies reporting the use of CAM in children with ARTI were identified using a targeted search of seven electronic databases and the grey literature. Data were extracted using a customised data extraction form and appraised using the McMaster critical review forms for quantitative and qualitative studies. Findings were synthesised in narrative form. The search identified 2261 papers, of which 22 studies were eligible for inclusion. The 22 studies reported the use of 118 distinct CAM interventions for the management of ARTI in children. Most (53%, n = 63) of these interventions represented biologically-based therapies, followed by whole medical systems/alternative medical systems (46%, n = 55). No studies reported the use of energy therapies, or manipulative and body-based methods, or mind-body therapies. A diverse range of CAM interventions are used in the management of ARTI in children. These interventions largely represent CAM use in the southern region of Asia - India, Pakistan and Bangladesh. Further research is needed to better understand the types of CAM used among children with ARTI in western countries. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Family functioning mediates the association between parental depression and low self-esteem in adolescents.

    PubMed

    Krug, Susann; Wittchen, Hans-Ulrich; Lieb, Roselind; Beesdo-Baum, Katja; Knappe, Susanne

    2016-10-01

    The negative impact of parental depression on offsprings' development has been repeatedly documented. There is however little research on the potential pathways contributing to this association. The present study examined the relationship between parental depressive disorders, family functioning and adolescents' self-esteem. A community-based sample of 1040 participants aged 14-17 years and their parents was assessed including direct and indirect information on parental psychopathology based on the Munich-Composite International Diagnostic Interview (M-CIDI). Family functioning and youth self-esteem were assessed by self-report questionnaires using the McMaster Family Assessment Device (FAD) in parents and the "Aussagen-Liste zum Selbstwertgefühl" in adolescents. Findings from multiple regression analyses indicated positive associations between parental depressive disorders and dimensions of dysfunctional family functioning as well as between dysfunctional familial affective involvement and youth's positive self-esteem. The relationship between parental depression and self-esteem was partly mediated by familial affective involvement. Associations may be underestimated, since incidence for depressive disorders spans to the third decade of life. Consensus diagnoses for parental depressive disorders were based on direct and indirect information for maximum use of available data, neglecting familial load, chronicity of parental depressive disorders or comorbid conditions. Thus, specificity of the findings for the family transmission of depressive disorders remains yet to be determined. Findings contribute to understanding of the pathways on how parental depression impairs offsprings' view of themselves, and to consider family functioning as a possible target for preventive interventions. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Effects of preoperative physiotherapy in hip osteoarthritis patients awaiting total hip replacement

    PubMed Central

    Czyżewska, Anna; Walesiak, Katarzyna; Krawczak, Karolina; Cabaj, Dominika; Górecki, Andrzej

    2014-01-01

    Introduction The World Health Organization (WHO) claimed osteoarthritis as a civilization-related disease. The effectiveness of preoperative physiotherapy among patients suffering hip osteoarthritis (OA) at the end of their conservative treatment is rarely described in the literature. The aim of this study was to assess the quality of life and musculoskeletal health status of patients who received preoperative physiotherapy before total hip replacement (THR) surgery within a year prior to admission for a scheduled THR and those who did not. Material and methods Forty-five patients, admitted to the Department of Orthopaedics and Traumatology of Locomotor System for elective total hip replacement surgery, were recruited for this study. The assessment consisted of a detailed interview using various questionnaires: the Harris Hip Score (HHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the 36-Item Short Form Health Survey (SF-36), and the Hip disability and Osteoarthritis Outcome Score (HOOS), as well as physical examination. Patients were assigned to groups based on their attendance of preoperative physiotherapy within a year prior to surgery. Results Among patients who received preoperative physiotherapy a significant improvement was found for pain, daily functioning, vitality, psychological health, social life, and (active and passive) internal rotation (p < 0.05). Conclusions Patients are not routinely referred to physiotherapy within a year before total hip replacement surgery. This study confirmed that pre-operative physiotherapy may have a positive influence on selected musculoskeletal system status indicators and quality of life in hip osteoarthritis patients awaiting surgery. PMID:25395951

  16. Health-related quality of life with long-term retention of the PROSthesis of Antibiotic Loaded Acrylic Cement system following infection resolution in low demand patients.

    PubMed

    Beaupre, Lauren A; Stampe, Kyle; Masson, Edward; O'Connor, Gregory; Clark, Marcia; Joffe, A Mark; Boychuk, Lesia R; Lavoie, Guy

    2017-01-01

    The study purpose was to (1) evaluate health-related quality of life (HRQL) with the PROSthesis of Antibiotic Loaded Acrylic Cement (PROSTALAC) in situ for infected total hip arthroplasty (THA), (2) determine infection resolution, and (3) compare subjects who underwent second stage surgery with those who retained the PROSTALAC on a longer term basis. Demographics, physical demand level, and comorbidities were recorded prospectively in 29 subjects followed to at least 24 months after initial PROSTALAC insertion. HRQL was evaluated using the Western Ontario McMaster Osteoarthritis Index (WOMAC) and RAND 36-Item Health Survey. Infection resolution was determined using a pre-specified clinical definition. Twenty-five of 29 (86%) subjects' infections resolved. Three subjects died, of whom two had resolved infections. For survivors, 22/26 (85%) completed HRQL evaluations. After PROSTALAC insertion, pain and function improved within 3-6 months and was retained at 24 months. Of those followed to 24 months, 7/22 (32%) subjects underwent second stage surgery. They were higher physical demand subjects ( p = 0.03) than those not undergoing second stage surgery. We found no difference in WOMAC scores at 24 months between those who underwent second stage surgery and those who retained the PROSTALAC ( p > 0.32). The PROSTALAC system for THA appears to allow acceptable HRQL while in situ for at least 2 years in low physical demand patients. Subjects with higher physical demand levels are more likely to undergo second stage surgery. Further evaluation is required to determine whether longer term PROSTALAC retention may be appropriate for specific patient groups.

  17. Perceived family functioning, adolescent psychopathology and quality of life in the general population: a 6-month follow-up study.

    PubMed

    Jozefiak, Thomas; Wallander, Jan L

    2016-04-01

    The aim of the study was to investigate whether perceived family functioning of adolescent is moderating or mediating the longitudinal association of adolescent internalizing and externalizing psychopathology with quality of life (QoL) after 6 months in the general population. Using a cluster sampling technique in one Norwegian county 1331, 10- to 16-year-old students were included in the study (51 % girls). Parents completed the Child Behavior Checklist for the assessment of adolescent psychopathology at Time 1. The students completed the General Functioning Scale of the McMaster Family Assessment Device and the Inventory of Life Quality in Children and Adolescents at time 2 6 months later. Psychopathology, family functioning and QoL were treated as latent variables in a structural equation model adjusted for sex, age and parent education. The regression coefficients for paths from psychopathology decreased (β = .199 for the internalizing and β = .102 for the externalizing model) in each case when including the indirect path via family functioning compared with the direct path from psychopathology to QoL. The sum of indirect effects on QoL via family functioning was significant for internalizing β = 0.093 (95 % CI 0.054-0.133) and externalizing β = 0.119 (95 % CI 0.076-0.162) psychopathology. Family functioning significantly mediated the longitudinal association between psychopathology and QoL. Because the family remains an important social domain for adolescents, it must be an important consideration when attempting to reduce or alleviate psychopathology in youth and improve the quality of their life experience throughout this period.

  18. Reliability and validity of the 12-item WHODAS 2.0 in patients with Kashin-Beck disease.

    PubMed

    Younus, Mohammad Imran; Wang, Di-Miao; Yu, Fang-Fang; Fang, Hua; Guo, Xiong

    2017-09-01

    The purpose of this study was to check the reliability and validity of the 12-item Chinese version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for the assessment of disability in patients with Kashin-Beck disease (KBD). We recruited 219 patients with KBD from the high-risk KBD area in the Shaanxi province, using stratified multistage random sampling. We assessed each patient using the Chinese version of the 12-item WHODAS 2.0 and the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC). Statistical evaluations of the instruments consisted of Cronbach's alpha, intraclass correlation coefficient (ICC), confirmatory factor analysis (CFA), and Pearson's correlation coefficient. Cronbach's alpha and ICC for the six domains ranged from 0.704 to 0.906 and 0.690 to 0.852, respectively. A six-factor structure fits the data well (CFI = 0.967, TLI = 0.944, RMSEA = 0.08). Regarding convergent validity, the four domains of the 12-item WHODAS 2.0 (getting around, self-care, life activity, and participation) showed moderate-to-strong correlation for all three domains of the WOMAC (0.428 < |r| < 0.804). Regarding divergent validity, the two domains of the 12-item WHODAS 2.0 (understanding and communication, and getting along with people) showed weak correlation for the three domains of WOMAC (0.182 < |r| < 0.295). The Chinese version of 12-item WHODAS 2.0 questionnaire is a reliable and valid instrument when administered to KBD patients.

  19. Validation of the Mini-OAKHQOL for use in patients with osteoarthritis in Spain.

    PubMed

    Gonzalez Sáenz de Tejada, Marta; Bilbao, Amaia; Herrera, Carmen; García, Lidia; Sarasqueta, Cristina; Escobar, Antonio

    2017-08-01

    The Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQOL) questionnaire osteoarthritis is specific to individuals with knee or hip osteoarthritis. The objective of this study was to perform a validation of the Mini-OAKHQOL for use in Spain in terms of its psychometric properties of reliability, validity and responsiveness. Patients with osteoarthritis from the waiting list for a joint replacement completed the OAKHQOL, Short Form 36 Health Survey and Western Ontario and McMaster Universities Osteoarthritis Index. Reliability was assessed in terms of internal consistency and test-retest data, and convergent validity using Spearman's correlation coefficient. Structural validity was investigated by confirmatory factor analysis, and Rasch analysis was used to examine the unidimensionality of the scales. Responsiveness was assessed by calculating effect sizes. Confirmatory factor analysis confirmed the five-factor model, and the results of the Rasch analyses supported the unidimensionality assumption, with infit and outfit statistics. Cronbach's alpha ranged from 0.76 to 0.89 for all except the social dimensions. Statistically significant differences were observed between patients with different degrees of disease severity on all dimensions. There was convergent validity among dimensions expected to be correlated. The OAKHQOL questionnaire showed good responsiveness, with large changes for all dimensions apart from the two social dimensions, which had small effect sizes. Results of the study support the view that the Spanish version of the Mini-OAKHQOL questionnaire is a valid instrument to measure health-related quality of life in patients with osteoarthritis of the lower limb.

  20. Adaptation and validation of the Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire for use in patients with osteoarthritis in Spain.

    PubMed

    Gonzalez Sáenz de Tejada, Marta; Escobar, Antonio; Herdman, Michael; Herrera, Carmen; García, Lidia; Sarasqueta, Cristina

    2011-12-01

    This study aims to adapt and validate the Spanish version of the Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire. The OAKHQOL was adapted into Spanish using a forward-backward translation methodology. The Spanish version was then validated in a prospective, mixed-design study of 759 patients with hip or knee osteoarthritis (OA). Patients completed the OAKHQOL, Short Form 36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index, and the EQ-5D. The internal consistency was evaluated using Cronbach's alpha. Convergent validity was assessed by examining correlations between the OAKHQOL and other patient-reported instruments; known groups' validity was assessed by determining the capacity of the OAKHQOL to discriminate between patients with different levels of disease severity measured using the Lequesne Index. Test-retest reliability was evaluated by calculating the intraclass correlation coefficient (ICC) for all OAKHQOL domains in 409 stable patients with OA. Responsiveness was evaluated by calculating effect sizes among 129 patients undergoing hip or knee replacement. Cronbach's alpha for the five domains of the OAKHQOL ranged from 0.60 to 0.93 while ICCs ranged from 0.75 to 0.81 for all domains except the two social domains. Statistically significant differences (p < 0.001) were observed between patients with different degrees of disease severity on all domains except "social support". The instrument showed convergent validity among hypothesized domains (p < 0.001). Results of the study supported that the Spanish version OAKHQOL questionnaire was a valid instrument to measure health-related quality of life in patients with OA of the lower limb.

  1. Translation, cross-cultural adaptation and validation of the Brazilian version of the Nonarthritic Hip Score.

    PubMed

    Del Castillo, Letícia Nunes Carreras; Leporace, Gustavo; Cardinot, Themis Moura; Levy, Roger Abramino; Oliveira, Liszt Palmeira de

    2013-01-01

    CONTEXT AND OBJECTIVE The Nonarthritic Hip Score (NAHS) is a clinical evaluation questionnaire that was developed in the English language to evaluate hip function in young and physically active patients. The aims of this study were to translate this questionnaire into the Brazilian Portuguese language, to adapt it to Brazilian culture and to validate it. DESIGN AND SETTING Cohort study conducted between 2008 and 2010, at Universidade do Estado do Rio de Janeiro (UERJ). METHODS Questions about physical activities and household chores were modified to better fit Brazilian culture. Reproducibility, internal consistency and validity (correlations with the Algofunctional Lequesne Index and the Western Ontario and McMaster Universities Arthritis Index [WOMAC]) were tested. The NAHS-Brazil, Lequesne and WOMAC questionnaires were applied to 64 young and physically active patients (mean age, 40.9 years; 31 women). RESULTS The intraclass correlation coefficient (which measures reproducibility) was 0.837 (P < 0.001). Bland-Altman plots revealed a mean error in the difference between the two measurements of 0.42. The internal consistency was confirmed through a Cronbach alpha of 0.944. The validity between NAHS-Brazil and Lequesne and between NAHS-Brazil and WOMAC showed high correlations, r = 0.7340 and r = 0.9073, respectively. NAHS-Brazil showed good validity with no floor or ceiling effects. CONCLUSION The NAHS was translated into the Brazilian Portuguese language and was cross-culturally adapted to Brazilian culture. It was shown to be a useful tool in clinical practice for assessing the quality of life of young and physically active patients with hip pain.

  2. Cross-cultural adaptation and validation of the Ankle Osteoarthritis Scale for use in French-speaking populations.

    PubMed

    Angers, Magalie; Svotelis, Amy; Balg, Frederic; Allard, Jean-Pascal

    2016-04-01

    The Ankle Osteoarthritis Scale (AOS) is a self-administered score specific for ankle osteoarthritis (OA) with excellent reliability and strong construct and criterion validity. Many recent randomized multicentre trials have used the AOS, and the involvement of the French-speaking population is limited by the absence of a French version. Our goal was to develop a French version and validate the psychometric properties to assure equivalence to the original English version. Translation was performed according to American Association of Orthopaedic Surgeons (AAOS) 2000 guidelines for cross-cultural adaptation. Similar to the validation process of the English AOS, we evaluated the psychometric properties of the French version (AOS-Fr): criterion validity (AOS-Fr v. Western Ontario and McMaster Universities Arthritis Index [WOMAC] and SF-36 scores), construct validity (AOS-Fr correlation to single heel-lift test), and reliability (AOS-Fr test-retest). Sixty healthy individuals tested a prefinal version of the AOS-Fr for comprehension, leading to modifications and a final version that was approved by C. Saltzman, author of the AOS. We then recruited patients with ankle OA for evaluation of the AOS-Fr psychometric properties. Twenty-eight patients with ankle OA participated in the evaluation. The AOS-Fr showed strong criterion validity (AOS:WOMAC r = 0.709 and AOS:SF-36 r = -0.654) and construct validity (r = 0.664) and proved to be reliable (test-retest intraclass correlation coefficient = 0.922). The AOS-Fr is a reliable and valid score equivalent to the English version in terms of psychometric properties, thus is available for use in multicentre trials.

  3. Existence of a neuropathic pain component in patients with osteoarthritis of the knee.

    PubMed

    Ohtori, Seiji; Orita, Sumihisa; Yamashita, Masaomi; Ishikawa, Tetsuhiro; Ito, Toshinori; Shigemura, Tomonori; Nishiyama, Hideki; Konno, Shin; Ohta, Hideyuki; Takaso, Masashi; Inoue, Gen; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Kuniyoshi, Kazuki; Aoki, Yasuchika; Arai, Gen; Miyagi, Masayuki; Kamoda, Hiroto; Suzkuki, Miyako; Nakamura, Junichi; Furuya, Takeo; Kubota, Gou; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Suzuki, Masahiko; Sasho, Takahisa; Nakagawa, Koichi; Toyone, Tomoaki; Takahashi, Kazuhisa

    2012-07-01

    Pain from osteoarthritis (OA) is generally classified as nociceptive (inflammatory). Animal models of knee OA have shown that sensory nerve fibers innervating the knee are significantly damaged with destruction of subchondral bone junction, and induce neuropathic pain (NP). Our objective was to examine NP in the knees of OA patients using painDETECT (an NP questionnaire) and to evaluate the relationship between NP, pain intensity, and stage of OA. Ninety-two knee OA patients were evaluated in this study. Pain scores using Visual Analogue Scales (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), painDETECT, duration of symptoms, severity of OA using the Kellgren-Lawrence (KL) system, and amount of joint fluid were evaluated and compared using a Spearman's correlation coefficient by rank test. Our study identified at least 5.4% of our knee OA patients as likely to have NP and 15.2% as possibly having NP. The painDETECT score was significantly correlated with the VAS and WOMAC pain severity. Compared with the painDETECT score, there was a tendency for positive correlation with the KL grade, and tendency for negative correlation with the existence and amount of joint fluid, but these correlations were not significant. PainDETECT scores classified 5.4% of pain from knee OA as NP. NP tended to be seen in patients with less joint fluid and increased KL grade, both of which corresponded to late stages of OA. It is important to consider the existence of NP in the treatment of knee OA pain.

  4. The international Hip Outcome Tool-33 (iHOT-33): multicenter validation and translation to Spanish.

    PubMed

    Ruiz-Ibán, Miguel Angel; Seijas, Roberto; Sallent, Andrea; Ares, Oscar; Marín-Peña, Oliver; Muriel, Alfonso; Cuéllar, Ricardo

    2015-05-20

    The international Hip Outcome Tool-33 (iHOT-33) is a 33-item self administered outcome measure based on a Visual Analogue Scale response format designed for young and active population with hip pathology. The aim of the present study is to translate and validate the iHOT-33 into Spanish. 97 patients undergoing hip arthroscopy were included in this prospective and multicenter study performed between January 2012 and May 2014. Crosscultural adaptation was used to translate iHOT-33 into Spanish. Patients completed the questionnaire before and after surgery. Feasibility, reliability, internal consistency, construct validity (correlation with Western Ontario and McMaster Universities Osteoarthritis Index), ceiling and floor effects and sensitivity to change were assessed for the present study. Mean age was 48 years old. Feasibility: 41.2 % patients had no blank questions, and 71.3 % of patients had fulfilled all but one or two questions. Reliability: ICC for the global questionnaire was 0.97, showing that the questionnaire is highly reproducible. Internal consistency: Cronbach's alpha was 0.98 for the global questionnaire. Construct validity: there was a high correlation with WOMAC (correlation coefficient >0.5). The Ceiling effect (taking into account the minimum detectable change) was 12.1 % and the floor effect was 21.6 %, for the global questionnaire. Large sensitivity to change was shown. the Spanish version of iHOT-33 has shown to be feasible, reliable and sensible to changes for patients undergoing hip arthroscopy. This validated translation of iHOT-33 allows for comparisons between studies involving either Spanish- or English-speaking patients. Prognostic study, Level I.

  5. What Are Normal Metal Ion Levels After Total Hip Arthroplasty? A Serologic Analysis of Four Bearing Surfaces.

    PubMed

    Barlow, Brian T; Ortiz, Philippe A; Boles, John W; Lee, Yuo-Yu; Padgett, Douglas E; Westrich, Geoffrey H

    2017-05-01

    The recent experiences with adverse local tissue reactions have highlighted the need to establish what are normal serum levels of cobalt (Co), chromium (Cr), and titanium (Ti) after hip arthroplasty. Serum Co, Cr, and Ti levels were measured in 80 nonconsecutive patients with well-functioning unilateral total hip arthroplasty and compared among 4 bearing surfaces: ceramic-on-ceramic (CoC); ceramic-on-polyethylene (CoP); metal-on-polyethylene (MoP), and dual mobility (DM). The preoperative and most recent University of California, Los Angeles (UCLA) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were compared among the different bearing surfaces. No significant difference was found among serum Co and Cr levels between the 4 bearing surface groups (P = .0609 and P = .1577). Secondary analysis comparing metal and ceramic femoral heads demonstrated that the metal group (MoP, modular dual mobility (Stryker Orthopedics, Mahwah, NJ) [metal]) had significant higher serum Co levels compared with the ceramic group (CoC, CoP, MDM [ceramic]) (1.05 mg/L ± 1.25 vs 0.59 mg/L ± 0.24; P = .0411). Spearman coefficient identified no correlation between metal ion levels and patient-reported outcome scores. No serum metal ion level differences were found among well-functioning total hip arthroplasty with modern bearing couples. Significantly higher serum Co levels were seen when comparing metal vs ceramic femoral heads in this study and warrants further investigation. Metal ion levels did not correlate with patient-reported outcome measures. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Cytokines as a predictor of clinical response following hip arthroscopy: minimum 2-year follow-up.

    PubMed

    Shapiro, Lauren M; Safran, Marc R; Maloney, William J; Goodman, Stuart B; Huddleston, James I; Bellino, Michael J; Scuderi, Gaetano J; Abrams, Geoffrey D

    2016-08-01

    Hip arthroscopy in patients with osteoarthritis has been shown to have suboptimal outcomes. Elevated cytokine concentrations in hip synovial fluid have previously been shown to be associated with cartilage pathology. The purpose of this study was to determine whether a relationship exists between hip synovial fluid cytokine concentration and clinical outcomes at a minimum of 2 years following hip arthroscopy. Seventeen patients without radiographic evidence of osteoarthritis had synovial fluid aspirated at time of portal establishment during hip arthroscopy. Analytes included fibronectin-aggrecan complex as well as a multiplex cytokine array. Patients completed the modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index and the International Hip Outcomes Tool pre-operatively and at a minimum of 2 years following surgery. Pre and post-operative scores were compared with a paired t-test, and the association between cytokine values and clinical outcome scores was performed with Pearson's correlation coefficient with an alpha value of 0.05 set as significant. Sixteen of seventeen patients completed 2-year follow-up questionnaires (94%). There was a significant increase in pre-operative to post-operative score for each clinical outcome measure. No statistically significant correlation was seen between any of the intra-operative cytokine values and either the 2-year follow-up scores or the change from pre-operative to final follow-up outcome values. No statistically significant associations were seen between hip synovial fluid cytokine concentrations and 2-year follow-up clinical outcome assessment scores for those undergoing hip arthroscopy.

  7. Efficacy of a multimodal physiotherapy treatment program for hip osteoarthritis: a randomised placebo-controlled trial protocol

    PubMed Central

    2010-01-01

    Background Hip osteoarthritis (OA) is a common condition leading to pain, disability and reduced quality of life. There is currently limited evidence to support the use of conservative, non-pharmacological treatments for hip OA. Exercise and manual therapy have both shown promise and are typically used together by physiotherapists to manage painful hip OA. The aim of this randomised controlled trial is to compare the efficacy of a physiotherapy treatment program with placebo treatment in reducing pain and improving physical function. Methods The trial will be conducted at the University of Melbourne Centre for Health, Exercise and Sports Medicine. 128 participants with hip pain greater or equal to 40/100 on visual analogue scale (VAS) and evidence of OA on x-ray will be recruited. Treatment will be provided by eight community physiotherapists in the Melbourne metropolitan region. The active physiotherapy treatment will comprise a semi-structured program of manual therapy and exercise plus education and advice. The placebo treatment will consist of sham ultrasound and the application of non-therapeutic gel. The participants and the study assessor will be blinded to the treatment allocation. Primary outcomes will be pain measured by VAS and physical function recorded on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) immediately after the 12 week intervention. Participants will also be followed up at 36 weeks post baseline. Conclusions The trial design has important strengths of reproducibility and reflecting contemporary physiotherapy practice. The findings from this randomised trial will provide evidence for the efficacy of a physiotherapy program for painful hip OA. Trial Registration Australian New Zealand Clinical Trials Registry reference: ACTRN12610000439044 PMID:20946621

  8. Adherence to the Mediterranean diet is associated with better quality of life: data from the Osteoarthritis Initiative.

    PubMed

    Veronese, Nicola; Stubbs, Brendon; Noale, Marianna; Solmi, Marco; Luchini, Claudio; Maggi, Stefania

    2016-11-01

    The Mediterranean diet has positively influenced various medical conditions, but only a paucity of studies has considered the relation between the Mediterranean diet and quality of life (QOL) among people living in North America. We investigated whether a higher adherence to the Mediterranean diet (aMED) was associated with better QOL and decreased pain, stiffness, disability, and depression in a large cohort of North Americans from the Osteoarthritis Initiative. aMED was evaluated through a validated Mediterranean diet score categorized into quintiles. Outcomes of interest were QOL [assessed with the 12-Item Short-Form Health Outcome Survey (SF-12)]; disability, pain, and stiffness [assessed in both knees with the Western Ontario and McMaster Universities Arthritis Index (WOMAC)]; and depressive symptoms [assessed with the Center for Epidemiologic Studies Depression Scale (CES-D)]. Of the 4470 participants (2605 women; mean age: 61.3 y), those with a higher aMED had significantly more favorable scores on all outcomes investigated (P < 0.0001 for all comparisons). After adjustment for potential confounders in linear regression analyses, a higher aMED was significantly associated with a higher SF-12 physical composite scale value (β: 0.10; 95% CI: 0.05, 0.15; P < 0.0001), lower WOMAC scores (except for stiffness), and lower CES-D scores (β: -0.05; 95% CI: -0.09, -0.01; P = 0.01). An adjusted logistic regression analysis, taking as reference those in the 2 highest quintiles of the aMED score, confirmed these findings. Higher aMED is associated with better QOL and decreased pain, disability, and depressive symptoms. This trial was registered at clinicaltrials.gov as NCT00080171. © 2016 American Society for Nutrition.

  9. Understanding the Relationship Between 3-Month and 2-Year Pain and Function Scores After Total Knee Arthroplasty for Osteoarthritis.

    PubMed

    Gandhi, Rajiv; Mahomed, Nizar N; Cram, Peter; Perruccio, Anthony V

    2018-05-01

    Research to understand predictors of poor outcomes after total knee arthroplasty (TKA) has largely focused on presurgery factors. We examined whether pain and function 3-month postsurgery were predictive of longer-term outcomes ascertained 2 years after TKA. Western Ontario McMaster University Osteoarthritis Index pain and physical function scores (scaled 0-20 and 0-68; higher = worse) were recorded pre-TKA and 3, 12, and 24 months post-TKA. A sequential series of regression models was used to examine the relative contribution of baseline score and baseline to 3-month and 3 to 12-month change score to explaining variability (R 2 ) in 2-year pain and function scores, with consideration for presurgery covariates. Data from 560 patients were analyzed. Mean pain and function scores improved significantly presurgery to 2 years postsurgery; 10-4 and 33-16 (P < .001), respectively. Considerable variability in 2-year scores was observed. Overall, 80.3% and 79.9% of changes in pain and function scores over the 2 years occurred within the first 3 months. Change over these 3 months explained the greatest proportion of variability in 2-year scores, 16% and 23% for pain and function, respectively. The influences of these early changes were similar to those of baseline status. Changes in patient-reported pain and function occurring within the first 3 months post-TKA strongly determine pain and function status at 2 years. Research to identify pre-/intra-/early postoperative factors associated with change in this early postoperative period that may be amenable to modification or used to better inform education and decision-making is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. An epidemiological study of intestinal parasites of dogs from Yucatan, Mexico, and their risk to public health.

    PubMed

    Rodríguez-Vivas, Roger Ivan; Gutierrez-Ruiz, Edwin; Bolio-González, Manuel Emilio; Ruiz-Piña, Hugo; Ortega-Pacheco, Antonio; Reyes-Novelo, Enrique; Manrique-Saide, Pablo; Aranda-Cirerol, Francisco; Lugo-Perez, J A

    2011-08-01

    The prevalence of intestinal parasites in dogs and factors associated were studied in a rural community of Yucatan (southern Mexico), with special attention to those gastrointestinal parasites potentially transmitted to man. One hundred thirty dogs from 91 households were studied. Fecal samples were processed by the centrifugation-flotation and the McMaster techniques. To determine factors associated with zoonotic parasites in dogs, univariate analysis was performed, using sex, age, and body condition as independent variables. Variables with p < 0.2 were analyzed by a logistic regression. Of 130 dogs, 104 were positive for the presence of intestinal parasites, representing a prevalence of 80%. Eggs of four species of helminths (Ancylostoma caninum, Thichuris vulpis, Toxocara canis, and Dipylidium caninum) and coccidian oocysts were detected. A. caninum was the most prevalent parasite (73.8%), followed by T. vulpis (25.4%), T. canis (6.2%), D. caninum (2.3%), and coccidian oocysts (2.3%). The majority of dogs were infected by only one species of parasite (70/130, 53.8%). Mixed infection caused by two or three zoonotic parasites were discovered in 21.3% (30/130) and 3.1% (4/130), respectively. A. caninum showed the highest egg output (42.3% of dogs had ≥ 500 eggs per gram). Factors associated with zoonotic parasites were age (<2 years old; odds ratio = 5.30, p = 0.029) and body condition (poor body condition; odds ratio = 6.69, p = 0.026). In conclusion, young dogs from rural Yucatan, Mexico, with poor body condition had a higher prevalence of intestinal zoonotic parasites as these factors were associated with a higher risk of becoming infected.

  11. Comparison of intra-articular tenoxicam and oral tenoxicam for pain and physical functioning in osteoarthritis of the knee.

    PubMed

    Unlu, Zeliha; Ay, Kamuran; Tuzun, Cigdem

    2006-02-01

    This study was designed to compare efficacy of local administration of a nonsteroidal anti-inflammatory drug with systemic administration in patients with osteoarthritis (OA) of the knee. For this purpose, intra-articular tenoxicam and oral tenoxicam therapies were applied and the improvement in control of pain and physical functioning were evaluated. A total of 69 patients with OA of the knee were randomized into three groups. Patients in the first group (41 knees of 23 patients) were treated for 1-3 weeks with once weekly intra-articular injection of tenoxicam 20 mg. Patients in the second group (45 knees of 26 patients) received 20 mg/day tenoxicam orally for 3 weeks and only physical exercises were applied to the third group (32 knees of 20 patients). Physical examination of the knee joint, Western Ontario and McMaster Universities Index and the Lequesne Algofunctional Index were used as outcome measurements at baseline, and the 1st, 3rd and 6th months. More significant improvement in pain and disability parameters was observed in groups 1 and 2 than group 3 compared with baseline measures. Among the patients' responses a few of the differences were statistically significant, more in favour of tenoxicam, and tenoxicam seemed to be superior to exercise alone especially at the final evaluation. There was no significant difference between the oral and intra-articular tenoxicam treatment regimens. The results of this study showed that treatment of OA of the knee with intra-articular tenoxicam is as effective as that with oral tenoxicam. It can be thought that intra-articular administration can be preferred to oral therapy due to minimal possibility of systemic side effects.

  12. Comparison of high, medium and low mobilization forces for increasing range of motion in patients with hip osteoarthritis: A randomized controlled trial.

    PubMed

    Estébanez-de-Miguel, Elena; Fortún-Agud, María; Jimenez-Del-Barrio, Sandra; Caudevilla-Polo, Santos; Bueno-Gracia, Elena; Tricás-Moreno, José Miguel

    2018-05-29

    Manual therapy has been shown to increase range of motion (ROM) in hip osteoarthritis (OA). However, the optimal intensity of force during joint mobilization is not known. To compare the effectiveness of high, medium and low mobilization forces for increasing range of motion (ROM) in patients with hip OA and to analyze the effect size of the mobilization. Randomized controlled trial. Sixty patients with unilateral hip OA were randomized to three groups: low, medium or high force mobilization group. Participants received three treatment sessions of long-axis distraction mobilization (LADM) in open packed position and distraction forces were measured at each treatment. Primary outcomes: passive hip ROM assessed before and after each session. pain recorded with Western Ontario and McMaster Universities (WOMAC) pain subscale before and after the three treatment sessions. Hip ROM increased significantly (p < 0.05) in the high-force mobilization group (flexion: 10.6°, extension: 8.0°, abduction:6.4°, adduction: 3.3°, external rotation: 5.6°, internal rotation: 7.6°). These improvements in hip ROM were statistically significant (p < 0.05) compared to the low-force group. There were no significant changes in the low-force and medium-force groups for hip ROM. No significant differences in hip pain were found between treatment groups. A high force LADM in open packed position significantly increased hip ROM in all planes of motion compared to a medium or low force mobilization in patients with hip OA. A specific intensity of force mobilization appears to be necessary for increasing ROM in hip OA. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Parental psychopathology, parenting styles, and the risk of social phobia in offspring: a prospective-longitudinal community study.

    PubMed

    Lieb, R; Wittchen, H U; Höfler, M; Fuetsch, M; Stein, M B; Merikangas, K R

    2000-09-01

    This article examines the associations between DSM-IV social phobia and parental psychopathology, parenting style, and characteristics of family functioning in a representative community sample of adolescents. Findings are based on baseline and first follow-up data of 1047 adolescents aged 14 to 17 years at baseline (response rate, 74.3%), and independent diagnostic interviews with one of their parents. Diagnostic assessments in parents and adolescents were based on the DSM-IV algorithms of the Munich-Composite International Diagnostic Interview. Parenting style (rejection, emotional warmth, and overprotection) was assessed by the Questionnaire of Recalled Parental Rearing Behavior, and family functioning (problem solving, communication, roles, affective responsiveness, affective involvement, and behavioral control) was assessed by the McMaster Family Assessment Device. There was a strong association between parental social phobia and social phobia among offspring (odds ratio [OR], 4.7; 95% confidence interval [CI], 1.6-13.5). Other forms of parental psychopathology also were associated with social phobia in adolescents (depression: OR, 3.6; 95% CI, 1.4-9.1; any anxiety disorder other than social phobia: OR, 3.5; 95% CI, 1.4-8.8; and any alcohol use disorder: OR, 3.0; 95% CI, 1.1-7.8). Parenting style, specifically parental overprotection (OR, 1.4; 95% CI, 1.0-1.9) and rejection (OR, 1.4; 95% CI, 1.1-1.9), was found to be associated with social phobia in respondents. Family functioning was not associated with respondents' social phobia. Data suggest that parental psychopathology, particularly social phobia and depression, and perceived parenting style (overprotection and rejection) are both associated with the development of social phobia in youth.

  14. Association Between Exercise Therapy Dose and Functional Improvements in the Early Postoperative Phase After Hip and Knee Arthroplasty: An Observational Study.

    PubMed

    Zech, Astrid; Hendrich, Simon; Pfeifer, Klaus

    2015-10-01

    To determine whether intensity and duration of standard exercise therapy are associated with changes in function after total hip arthroplasty (THA) and total knee arthroplasty (TKA). Prospective cohort study. Orthopedic inpatient rehabilitation center. A total of 123 patients 2 weeks after THA (n = 58; age, 62.5 ± 10.4 years) and TKA (n = 65; age, 66.6 ± 7.6 years). Standard rehabilitation (hands-on physiotherapy, group exercise therapy, strength training, cycle ergometer therapy, continuous passive motion therapy, and water exercise therapy). The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and hip and knee range of motion (ROM) were assessed before and after inpatient rehabilitation. The individual rehabilitation period varied between 12-25 days and included 48.1 ± 12.5 (THA) or 41.9 ± 9.7 (TKA) exercise interventions with intensities between 9.6 and 14.0 points on the Borg Rate of Perceived Exertion Scale. WOMAC pain (P < .001), stiffness (P < .001), and function (P < .001), as well as hip (P < .001) and knee (P < .001) ROM, improved significantly in THA and TKA patients. Analysis of covariance showed that these changes could not be explained by the total duration or mean intensity of exercise therapy. The findings show a low dose-response relationship between early postoperative exercise therapy and the improvements in function or ROM after THA and TKA. Although the findings raise questions about the efficacy of existing rehabilitation programs, the small sample size, single setting, and geographic differences in postoperative treatment standards limit the generalizability of findings. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  15. Revision Total Knee Arthroplasty with Metaphyseal Sleeves without Stem: Short-Term Results

    PubMed Central

    Stefani, Giacomo; Mattiuzzo, Valerio; Prestini, Greta

    2017-01-01

    Purpose  The aim of this study was to evaluate the efficacy of revision total knee arthroplasty (TKA) with cementless metaphyseal sleeves without stems either in the femoral or tibial side or in both. Methods  In this retrospective study, 51 patients (51 knees) operated in the period 2010 to 2015 met the above-mentioned criteria and were invited to a medical examination including X-rays. Forty-six were available for the study. Mean follow-up was 37 months. Knee Society score (KSS) (objective knee score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of motion (ROM) were used as outcome scores and compared with baseline values. X-rays were also examined and compared with postoperative exams to evaluate the presence of loosening, radiolucent lines, and bone ingrowth. Satisfaction of the patients was also investigated using a linear scale from 1 to 10. Results  KSS improved from 39 to 77 ( p  < 0.01); WOMAC score improved from 76 to 41 ( p  < 0.01). Twenty-four (52%) patients were satisfied, 15 (32%) were partially satisfied, and 7 (16%) were unsatisfied. ROM improved from 93 to 96 degrees (nonsignificant difference). X-rays showed no loosening of the implants, radiolucent lines in 4 patients (3 of them were asymptomatic) and bone ingrowth in 43 out of 46 patients. Conclusion  In this short-term retrospective study, the use of sleeves without stem was a safe and effective procedure in revision TKA. We found a significant improvement in clinical results compared with baseline values and no signs of implant loosening. Level of Evidence  Level IV, therapeutic case series. PMID:29270557

  16. Knee manipulation under anaesthetic following total knee arthroplasty: a matched cohort design.

    PubMed

    Dzaja, I; Vasarhelyi, E M; Lanting, B A; Naudie, D D; Howard, J L; Somerville, L; McCalden, R W; MacDonald, S J

    2015-12-01

    The purpose of this study was to compare clinical outcomes of total knee arthroplasty (TKA) after manipulation under anaesthesia (MUA) for post-operative stiffness with a matched cohort of TKA patients who did not requre MUA. In total 72 patients (mean age 59.8 years, 42 to 83) who underwent MUA following TKA were identified from our prospective database and compared with a matched cohort of patients who had undergone TKA without subsequent MUA. Patients were evaluated for range of movement (ROM) and clinical outcome scores (Western Ontario and McMaster Universities Arthritis Index, Short-Form Health Survey, and Knee Society Clinical Rating System) at a mean follow-up of 36.4 months (12 to 120). MUA took place at a mean of nine weeks (5 to 18) after TKA. In patients who required MUA, mean flexion deformity improved from 10° (0° to 25°) to 4.4° (0° to 15°) (p < 0.001), and mean range of flexion improved from 79.8° (65° to 95°) to 116° (80° to 130°) (p < 0.001). There were no statistically significant differences in ROM or functional outcome scores at three months, one year, or two years between those who required MUA and those who did not. There were no complications associated with manipulation. At most recent follow-up, patients requiring MUA achieved equivalent ROM and clinical outcome scores when compared with a matched control group. While other studies have focused on ROM after manipulation, the current study adds to current literature by supplementing this with functional outcome scores. ©2015 The British Editorial Society of Bone & Joint Surgery.

  17. History and development of evidence-based medicine.

    PubMed

    Claridge, Jeffrey A; Fabian, Timothy C

    2005-05-01

    This article illustrates the timeline of the development of evidence-based medicine (EBM). The term "evidence-based medicine" is relatively new. In fact, as far as we can tell, investigators from McMaster's University began using the term during the 1990s. EBM was defined as "a systemic approach to analyze published research as the basis of clinical decision making." Then in 1996, the term was more formally defined by Sacket et al., who stated that EBM was "the conscientious and judicious use of current best evidence from clinical care research in the management of individual patients." Ancient era EBM consists of ancient historical or anecdotal accounts of what may be loosely termed EBM. This was followed by the development of the renaissance era of EBM, which began roughly during the seventeenth century. During this era personal journals were kept and textbooks began to become more prominent. This was followed by the 1900s, during an era we term the transitional era of EBM (1900-1970s). Knowledge during this era could be shared more easily in textbooks and eventually peer-reviewed journals. Finally, during the 1970s we enter the modern era of EBM. Technology has had a large role in the advancement of EBM. Computers and database software have allowed compilation of large amounts of data. The Index Medicus has become a medical dinosaur of the past that students of today likely do not recognize. The Internet has also allowed incredible access to masses of data and information. However, we must be careful with an overabundance of "unfiltered" data. As history, as clearly shown us, evidence and data do not immediately translate into evidence based practice.

  18. Can We Predict Those With Osteoarthritis Who Will Worsen Following a Chronic Disease Management Program?

    PubMed

    Eyles, Jillian P; Mills, Kathryn; Lucas, Barbara R; Williams, Matthew J; Makovey, Joanna; Teoh, Laurence; Hunter, David J

    2016-09-01

    To identify predictors of worsening symptoms and overall health of the treated hip or knee joint following 26 weeks of a nonsurgical chronic disease management program for hip and knee osteoarthritis (OA) and to examine the consistency of these predictors across 3 definitions of worsening. This prospective cohort study followed 539 participants of the program for 26 weeks. The 3 definitions of worsening included symptomatic worsening based on change in the Western Ontario and McMaster Universities Osteoarthritis Index Global score (WOMAC-G) measuring pain, stiffness, and function; a transition scale that asked about overall health of the treated hip or knee joint; and a composite outcome including both. Multivariate logistic regression models were constructed for the 3 definitions of worsening. Complete data were available for 386 participants: mean age was 66.3 years, 69% were female, 85% reported knee joint pain as primary symptom (signal joint), 46% were waitlisted for total joint arthroplasty (TJA). TJA waitlist status, signal joint, 6-Minute Walk Test (6MWT), depressive symptoms, pain, and age were independently associated with at least 1 definition of worsening. TJA waitlist status and 6MWT remained in the multivariate models for the transition and composite definitions of worsening. Participants reporting worsening on the transition scale did not consistently meet the WOMAC-G definition of worsening symptoms. TJA waitlist status was predictive of the composite definition of worsening, a trend apparent for the transition definition. However, variables that predict worsening remain largely unknown. Further research is required to direct comprehensive and targeted management of patients with hip and knee OA. © 2016, American College of Rheumatology.

  19. Corticosteroid transdermal delivery significantly improves arthritis pain and functional disability.

    PubMed

    Iannitti, Tommaso; McDermott, Michael F; Laurino, Carmen; Malagoli, Andrea; Palmieri, Beniamino

    2017-02-01

    Arthritis is characterized by pain and functional limitation affecting the patients' quality of life. We performed a clinical study to investigate the efficacy of a betamethasone valerate medicated plaster (Betesil) in improving pain and functional disability in patients with arthritis and osteoarthritis. We enrolled 104 patients affected by osteoarthritis (n = 40) or arthritis (n = 64) in different joints. Patients received diclofenac sodium cream (2 g, four times a day) or a 2.25-mg dose of Betesil applied to the painful joint every night before bedtime for 10 days. Pain and functional disability were assessed, by the Visual Analogue Scale (VAS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores. Redness was assessed by clinical inspection, and edema by the "fovea sign" method. C-reactive protein (CRP) was also measured; CRP can be used to cost-effectively monitor the pharmacological treatment efficacy and is increased during the acute-phase response, returning to physiological values after tissue recovery and functional restoration. All measurements were at baseline and at 10-day follow-up. At 10-day follow-up, a greater improvement in VAS and WOMAC pain and WOMAC stiffness and functional limitation scores from baseline was observed in patients treated with Betesil compared with diclofenac (all p < 0.01). At 10-day follow-up, improvement in redness, edema, and CRP levels from baseline was also greater in patients treated with Betesil compared with diclofenac (all p < 0.01). This study demonstrates the safety and efficacy of transdermal delivery of betamethasone valerate in patients affected by arthritis and osteoarthritis.

  20. Prevalence, Associated Risk Factors, and Phylogenetic Analysis of Toxocara vitulorum Infection in Yaks on the Qinghai Tibetan Plateau, China

    PubMed Central

    Li, Kun; Lan, Yanfang; Luo, Houqiang; Zhang, Hui; Liu, Dongyu; Zhang, Lihong; Gui, Rui; Wang, Lei; Shahzad, Muhammad; Sizhu, Suolang; Li, Jiakui; Chamba, Yangzom

    2016-01-01

    Toxocara vitulorum has been rarely reported in yaks at high altitudes and remote areas of Sichuan Province of Tibetan Plateau of China. The current study was designed to investigate the prevalence, associated risk factors, and phylogenetic characteristics of T. vitulorum in yak calves on the Qinghai Tibetan plateau. Fecal samples were collected from 891 yak calves and were examined for the presence of T. vitulorum eggs by the McMaster technique. A multivariable logistic regression model was employed to explore variables potentially associated with exposure to T. vitulorum infection. T. vitulorum specimens were collected from the feces of yaks in Hongyuan of Sichuan Province, China. DNA was extracted from ascaris. After PCR amplification, the sequencing of ND1 gene was carried out and phylogenetic analyses was performed by MEGA 6.0 software. The results showed that 64 (20.1%; 95% CI 15.8–24.9%), 75 (17.2; 13.8–21.1), 29 (40.9; 29.3–53.2), and 5 (7.6; 2.5–16.8) yak calves were detected out to excrete T. vitulorum eggs in yak calve feces in Qinghai, Tibet, Sichuan, and Gansu, respectively. The present study revealed that high infection and mortality by T. vitulorum is wildly spread on the Qinghai Tibetan plateau, China by fecal examination. Geographical origin, ages, and fecal consistencies are the risk factors associated with T. vitulorum prevalence by logistic regression analysis. Molecular detection and phylogenetic analysis of ND1 gene of T. vitulorum indicated that T. vitulorum in the yak calves on the Qinghai Tibetan plateau are homologous to preveiously studies reported. PMID:27853122

  1. Effects of internet-based pain coping skills training prior to home exercise for individuals with hip osteoarthritis (HOPE trial): a randomised controlled trial.

    PubMed

    Bennell, Kim L; Nelligan, Rachel K; Rini, Christine; Keefe, Francis J; Kasza, Jessica; French, Simon; Forbes, Andrew; Dobson, Fiona; Abbott, J Haxby; Dalwood, Andrew; Harris, Anthony; Vicenzino, Bill; Hodges, Paul W; Hinman, Rana S

    2018-05-22

    This assessor-, therapist- and participant-blinded randomised controlled trial evaluated the effects of an automated internet-based pain coping skills training (PCST) program prior to home exercise for people with clinically-diagnosed hip osteoarthritis (OA). 144 people were randomised to either the PCST group or the comparator group. In the first 8 weeks, the PCST group received online education and PCST while the comparison group received online education only. From weeks 8-24, both groups visited a physiotherapist 5 times for home exercise prescription. Assessments were performed at baseline, 8, 24 and 52 weeks. Primary outcomes were hip pain on walking (11-point numerical rating scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) at 24 weeks. Secondary outcomes were other measures of pain, quality-of-life, global change, self-efficacy, pain coping, pain catastrophizing, depression, anxiety, stress, physical activity and adverse events. Primary outcomes were completed by 137 (95%), 131 (91%) and 127 (88%) participants at 8, 24 and 52 weeks, respectively. There were no significant between-group differences in primary outcomes at week 24 (change in: walking pain (mean difference 0.5 units; 95%CI, -0.3 to 1.3) and function (-0.9 units; 95%CI, -4.8 to 2.9)), with both groups showing clinically-relevant improvements. At week 8, the PCST group had greater improvements in function, pain coping and global improvement than comparison. Greater pain coping improvements persisted at 24 and 52 weeks. In summary, online PCST immediately improved pain coping and function but did not confer additional benefits to a subsequent exercise program, despite sustained pain coping improvements.

  2. Severity of Coexisting Patellofemoral Disease is Associated with Increased Impairments and Functional Limitations in Patients with Knee Osteoarthritis

    PubMed Central

    Farrokhi, Shawn; Piva, Sara R.; Gil, Alexandra B.; Oddis, Chester V.; Brooks, Maria M.; Fitzgerald, G. Kelley

    2012-01-01

    Objective To evaluate the association between severity of coexisting patellofemoral (PF) disease with lower limb impairments and functional limitations in patients with tibiofemoral (TF) osteoarthritis (OA). Methods Radiographic views of the TF and PF compartments, knee extension strength and knee range of motion were obtained for 167 patients with knee OA. Additionally, knee-specific symptoms and functional limitations were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Activities of Daily Living Scale (ADLS). Results “Moderate/Severe PFOA” was associated with lower knee extension strength (1.4±0.5 Nm/BW) compared to “No PFOA” (1.8±0.5 Nm/BW). Additionally, total knee range of motion was significantly lower for patients with “Moderate/Severe PFOA” (120.8°±14.4°) compared to “No PFOA” (133.5°±10.7°) and “Mild PFOA” (125.8°±13.0°). “Moderate/Severe PFOA” and “Mild PFOA” were also associated with less pain while standing (OR= 0.2; 95% CI: 0.1,0.7 and OR= 0.2; 95% CI: 0.1,0.6, respectively) on the WOMAC and “Moderate/Severe PFOA” was associated with greater difficulty with going downstairs (OR=2.9; 95% CI: 1.0,8.1) on the ADLS. Conclusion It appears that knees with more severe coexisting PF disease demonstrate features distinct from those observed in TFOA in isolation or in combination with mild PF disease. Treatment strategies targeting the PF joint may be warranted to mitigate the specific lower limb impairments and functional problems present in this patient population. PMID:23045243

  3. McMaster-Toronto Arthritis Patient Preference Disability Questionnaire Sensitivity to Change in Low Back Pain: Influence of Shifts in Priorities

    PubMed Central

    Sanchez, Katherine; Papelard, Agathe; Nguyen, Christelle; Bendeddouche, Imad; Jousse, Marylène; Rannou, François; Revel, Michel; Poiraudeau, Serge

    2011-01-01

    Objective To assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) in chronic low back pain (CLBP) and shifts in patients' priorities of disabling activities over time. Methods A prospective longitudinal survey of 100 patients (38 males) with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC), Hospital Anxiety and Depression scale (HAD), Fear-Avoidance Beliefs Questionnaire (FABQ), Coping Strategies Questionnaire (CSQ), and pain and handicap visual analogue scales (VASs). Patients' perceived improvement or worsening of condition was assessed at 6 months. Effect size (ES) and Standardized response mean (SRM) and effect size (ES) were used to evaluate sensitivity to change of the MACTAR. Results The MACTAR SRM and ES values (SRM = 0.25; ES = 0.37) were among the highest for the instruments evaluated. For patients considering their condition as improved, the SRM was 0.66 and the ES 1. The 3 disability domains, classified by the International Classification of Functioning, Disability and Health (ICF), most often cited as priorities at baseline remained the most cited at follow-up: mobility (40.9% of patients); community, social and civic life (22.7%); and domestic life (22.4%). At 6 months, 48 patients shifted their priorities, for a decrease in MACTAR SRM and ES values for patients considering their condition improved and an increase in these values for those considering their condition deteriorated. Conclusions Although the MACTAR has similar sensitivity to change as other outcome measures widely used in CLBP, shifts in patient priorities over time are common and influence scores and sensitivity to change. PMID:21629777

  4. A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis.

    PubMed

    Sánchez, Mikel; Fiz, Nicolás; Azofra, Juan; Usabiaga, Jaime; Aduriz Recalde, Enmanuel; Garcia Gutierrez, Antonio; Albillos, Javier; Gárate, Ramón; Aguirre, Jose Javier; Padilla, Sabino; Orive, Gorka; Anitua, Eduardo

    2012-08-01

    This multicenter, double-blind clinical trial evaluated and compared the efficacy and safety of PRGF-Endoret (BTI Biotechnology Institute, Vitoria-Gasteiz, Spain), an autologous biological therapy for regenerative purposes, versus hyaluronic acid (HA) as a short-term treatment for knee pain from osteoarthritis. We randomly assigned 176 patients with symptomatic knee osteoarthritis to receive infiltrations with PRGF-Endoret or with HA (3 injections on a weekly basis). The primary outcome measure was a 50% decrease in knee pain from baseline to week 24. As secondary outcomes, we also assessed pain, stiffness, and physical function using the Western Ontario and McMaster Universities Osteoarthritis Index; the rate of response using the criteria of the Outcome Measures for Rheumatology Committee and Osteoarthritis Research Society International Standing Committee for Clinical Trials Response Criteria Initiative (OMERACT-OARSI); and safety. The mean age of the patients was 59.8 years, and 52% were women. Compared with the rate of response to HA, the rate of response to PRGF-Endoret was 14.1 percentage points higher (95% confidence interval, 0.5 to 27.6; P = .044). Regarding the secondary outcome measures, the rate of response to PRGF-Endoret was higher in all cases, although no significant differences were reached. Adverse events were mild and evenly distributed between the groups. Plasma rich in growth factors showed superior short-term results when compared with HA in a randomized controlled trial, with a comparable safety profile, in alleviating symptoms of mild to moderate osteoarthritis of the knee. Level I, randomized controlled multicenter trial. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Midterm results of treatment with a retrograde nail for supracondylar periprosthetic fractures of the femur following total knee arthroplasty.

    PubMed

    Gliatis, John; Megas, Panagiotis; Panagiotopoulos, Elias; Lambiris, Elias

    2005-03-01

    Although the short-term results of supracondylar periprosthetic fractures treated with retrograde nailing have been satisfactory, there is always a concern about the long-term survival of the prosthesis. The aim of the study was to evaluate fracture healing and knee functional outcome with a follow-up time of at least 2 years in periprosthetic fractures of the knee treated with a supracondylar nail. Cohort study. There were 9 patients with 10 periprosthetic fractures. In 1 patient, the fracture occurred intraoperatively. In the others, the time between the total knee arthroplasty and the periprosthetic fracture ranged between 2 weeks and 7 years (average time: 2.78 years). The mean follow-up was 34.5 months (25-52 months). The Western Ontario and McMaster Universities index was used to evaluate the functional result postoperatively using the paired t test as the statistical test. Fracture union was assessed with plain x-rays. All the fractures united within 3 months. One fracture united in extreme valgus (35 degrees) and was revised to a stemmed total knee replacement. There were no infections and no prosthesis loosening. The paired t test before the fracture and after the operation demonstrated no statistically significant differences; however, there was a trend toward lower functional score postoperatively. It appears that retrograde nailing is a reliable technique to treat periprosthetic supracondylar fractures. It provides adequate stability until fracture union. The morbidity of the operation is minimal, and the complication rate is low. The midterm results in our study showed that none of the prostheses required revision. In our opinion, it is the treatment of choice for a periprosthetic fracture when the prosthesis is stable.

  6. Phase 3 trial of domiciliary humidification to mitigate acute mucosal toxicity during radiation therapy for head-and-neck cancer: first report of Trans Tasman Radiation Oncology Group (TROG) 07.03 RadioHUM study.

    PubMed

    Macann, Andrew; Fua, Tsien; Milross, Chris G; Porceddu, Sandro V; Penniment, Michael; Wratten, Chris; Krawitz, Hedley; Poulsen, Michael; Tang, Colin I; Morton, Randall P; Hay, K David; Thomson, Vicki; Bell, Melanie L; King, Madeleine T; Fraser-Browne, Carol L; Hockey, Hans-Ulrich P

    2014-03-01

    To assess the impact of domicile-based humidification on symptom burden during radiation therapy (RT) for head-and-neck (H&N) cancer. From June 2007 through June 2011, 210 patients with H&N cancer receiving RT were randomized to either a control arm or to receive humidification using the Fisher & Paykel Healthcare MR880 humidifier. Humidification commenced on day 1 of RT and continued until Common Terminology Criteria for Adverse Events (CTCAE), version 3.0, clinical mucositis (CMuc) grade ≤1 occurred. Forty-three patients (42%) met a defined benchmark for humidification compliance and contributed to per protocol (PP) analysis. Acute toxicities, hospitalizations, and feeding tube events were recorded prospectively. The McMaster University Head and Neck Radiotherapy Questionnaire (HNRQ) was used for patient-reported outcomes. The primary endpoint was area under the curve (AUC) for CMuc grade ≥2. There were no significant differences in AUC for CMuc ≥2 between the 2 arms. Humidification patients had significantly fewer days in hospital (P=.017). In compliant PP patients, the AUC for CTCAE functional mucositis score (FMuc) ≥2 was significantly reduced (P=.009), and the proportion who never required a feeding tube was significantly greater (P=.04). HNRQ PP analysis estimates also in the direction favoring humidification with less symptom severity, although differences at most time points did not reach significance. TROG 07.03 has provided efficacy signals consistent with a role for humidification in reducing symptom burden from mucositis, but the influence of humidification compliance on the results moderates recommendations regarding its practical utility. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Comparing conventional physical therapy rehabilitation with neuromuscular electrical stimulation after TKA.

    PubMed

    Levine, Michael; McElroy, Karen; Stakich, Valerie; Cicco, Jodie

    2013-03-01

    Rehabilitation following total knee arthroplasty (TKA) is a costly, cumbersome, and often painful process. Physical therapy contributes to the successful outcome of TKA but can be expensive. Alternative methods of obtaining good functional results that help minimize costs are desirable. Neuromuscular electrical stimulation (NMES) is a potential option. Neuromuscular electrical stimulation has been shown to increase quadriceps muscle strength and activation following TKA. Functional scores also improve following TKA when NMES is added to conventional therapy protocols vs therapy alone. The authors hypothesized that rehabilitation managed by a physical therapist would not result in a functional advantage for patients undergoing TKA when compared with NMES and an unsupervised at-home range of motion exercise program and that patient satisfaction would not differ between the 2 groups. Seventy patients were randomized into a postoperative protocol of conventional physical therapy with a licensed therapist, including range of motion exercises and strengthening exercises, or into a program of NMES and range of motion exercises performed at home without therapist supervision. Noninferiority of the NMES program was obtained 6 weeks postoperatively (Knee Society pain/function scores, Western Ontario and McMaster Universities Osteoarthritis Index, flexion). Noninferiority was shown 6 months postoperatively for all parameters. The results suggest that rehabilitation managed by a physical therapist results in no functional advantage or difference in patient satisfaction when compared with NMES and an unsupervised at-home range of motion program. Neuromuscular electrical stimulation and unsupervised at-home range of motion exercises may provide an option for reducing the cost of the postoperative TKA recovery process without compromising quadriceps strength or patient satisfaction. Copyright 2013, SLACK Incorporated.

  8. A longitudinal study to explain the pain-depression link in older adults with osteoarthritis.

    PubMed

    Hawker, Gillian A; Gignac, Monique A M; Badley, Elizabeth; Davis, Aileen M; French, Melissa R; Li, Ye; Perruccio, Anthony V; Power, J Denise; Sale, Joanna; Lou, Wendy

    2011-10-01

    To evaluate whether osteoarthritis (OA) pain determines depressed mood, taking into consideration fatigue and disability and controlling for other factors. In a community cohort with hip/knee OA, telephone interviews assessed OA pain and disability (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), fatigue (Multidimensional Fatigue Symptom Inventory), depressed mood (Center for Epidemiologic Studies Depression Scale), and covariates (demographics, self-rated health, comorbidity, pain coping, pain catastrophizing, and social support) at 3 time points over 2 years. Drawing on previous research, a path model was developed to test the interrelationships among the key concepts (pain, depression, fatigue, disability) over time, controlling for covariates. The baseline mean age was 75.4 years; 78.5% of the subjects were women, 37.2% were living alone, and 15.5% had ≥3 comorbid conditions. WOMAC scores indicated moderate OA symptoms and disability. From the final model with 529 subjects, adjusting for covariates, we found that current OA pain strongly predicted future fatigue and disability (both short and long term), that fatigue and disability in turn predicted future depressed mood, that depressed mood and fatigue were interrelated such that depressed mood exacerbated fatigue and vice versa, and that fatigue and disability, but not depressed mood, led to worsening of OA pain. Controlling for other factors, OA pain determined subsequent depressed mood through its effect on fatigue and disability. These effects led to worsening of pain and disability over time. These results support the need for improved pain management in OA to prevent or attenuate the downstream effects of pain on disability and mood. Copyright © 2011 by the American College of Rheumatology.

  9. A Prospective Randomized Peri- and Post-Operative Comparison of the Minimally Invasive Anterolateral Approach Versus the Lateral Approach

    PubMed Central

    Landgraeber, Stefan; Quitmann, Henning; Güth, Sebastian; Haversath, Marcel; Kowalczyk, Wojciech; Kecskeméthy, Andrés; Heep, Hansjörg; Jäger, Marcus

    2013-01-01

    There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip score (HHS) were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045). But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study. PMID:24191179

  10. Family Functioning in Suicidal Inpatients With Intimate Partner Violence

    PubMed Central

    Heru, Alison M.; Stuart, Gregory L.; Recupero, Patricia Ryan

    2007-01-01

    Background: Intimate partner violence (IPV) is commonly bidirectional with both partners perpetrating and being victims of aggressive behaviors. In these couples, family dysfunction is reported across a broad range of family functions: communication, intimacy, problem solving, expression or control of anger, and designation of relationship roles. This study reports on the perceived family functioning of suicidal inpatients. Method: In this descriptive, cross-sectional study of adult suicidal inpatients, participants completed assessments of recent IPV and family functioning. Recruited patients were between 18 and 65 years of age and English fluent, had suicidal ideation, and were living with an intimate partner for at least the past 6 months. Intimate partner violence was assessed using the Conflict Tactics Scale-Revised, and family functioning was measured using the McMaster Family Assessment Device. The study was conducted from August 2004 through February 2005. Results: In 110 inpatients with suicidal ideation and IPV, family functioning was perceived as poor across many domains, although patients did report family strengths. Gender differences were not found in the overall prevalence of IPV, but when the sample was divided into good and poor family functioning, women with poorer family functioning reported more psychological abuse by a partner. For both genders, physical and psychological victimization was associated with poorer family functioning. Conclusion: Among psychiatric inpatients with suicidal ideation, IPV occurred in relationships characterized by general dysfunction. Poorer general family functioning was associated with the perception of victimization for both genders. The high prevalence of bidirectional IPV highlights the need for the development of couples treatment for this population of suicidal psychiatric inpatients. PMID:18185819

  11. RELATIONSHIP BETWEEN ISOMETRIC THIGH MUSCLE STRENGTH AND MINIMAL CLINICALLY IMPORTANT DIFFERENCES (MCIDS) IN KNEE FUNCTION IN OSTEOARTHRITIS – DATA FROM THE OSTEOARTHRITIS INITIATIVE

    PubMed Central

    Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

    2014-01-01

    Objective To determine the relationship between thigh muscle strength and clinically relevant differences in self-assessed lower limb function. Methods Isometric knee extensor and flexor strength of 4553 Osteoarthritis Initiative participants (2651 women/1902 men) was related to Western Ontario McMasters Universities (WOMAC) physical function scores by linear regression. Further, groups of Male and female participant strata with minimal clinically important differences (MCIDs) in WOMAC function scores (6/68) were compared across the full range of observed values, and to participants without functional deficits (WOMAC=0). The effect of WOMAC knee pain and body mass index on the above relationships was explored using stepwise regression. Results Per regression equations, a 3.7% reduction in extensor and a 4.0% reduction in flexor strength were associated with an MCID in WOMAC function in women, and a 3.6%/4.8% reduction in men. For strength divided by body weight, reductions were 5.2%/6.7% in women and 5.8%/6.7% in men. Comparing MCID strata across the full observed range of WOMAC function confirmed the above estimates and did not suggest non-linear relationships across the spectrum of observed values. WOMAC pain correlated strongly with WOMAC function, but extensor (and flexor) muscle strength contributed significant independent information. Conclusion Reductions of approximately 4% in isometric muscle strength and of 6% in strength/weight were related to a clinically relevant difference in WOMAC functional disability. Longitudinal studies will need to confirm these relationships within persons. Muscle extensor (and flexor) strength (per body weight) provided significant independent information in addition to pain in explaining variability in lower limb function. PMID:25303012

  12. Dissecting through barriers: A follow-up study on the long-term effects of interprofessional education in a dissection course with healthcare professional students.

    PubMed

    Zheng, Yu Hang Eric; Palombella, Andrew; Salfi, Jenn; Wainman, Bruce

    2018-04-16

    Several studies have shown significant improvements in the attitudes and perceptions of healthcare professional students toward interprofessional education (IPE) immediately following intervention with IPE courses. However, there remains little evidence on the lasting effects of IPE courses and the long-term influences of these IPE experiences are poorly documented. The purpose of this study is to assess the long-term effects of an intensive, ten-week interprofessional gross anatomy dissection course at McMaster University. Attitudes and perceptions of past participants towards interprofessional learning were evaluated, now that they have started working with other healthcare professionals outside of the IPE course setting. Thirty-four past participants who have clinical experience working in interprofessional settings or are currently working in the healthcare field completed a follow-up questionnaire consisting of a modified Readiness for Interprofessional Learning Scale (RIPLS) and open-ended questions. Quantitative analysis revealed a significant decrease in their attitude towards teamwork and collaboration and respect for other health professions, but a significant improvement in their understanding of roles and responsibilities compared to their results immediately after the IPE intervention. Qualitative analysis of open-ended questions revealed several themes such as developing interprofessional competencies, developing relationships, and remembering the strengths of the IPE dissection course. The results of this study indicate that the IPE experience in anatomy was highly valued by the students and that past participants maintain a clear understanding of their scope of practice, but the reality of clinical practice may have eroded gains made in the program. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

  13. Long term use of analgesics and risk of osteoarthritis progressions and knee replacement: propensity score matched cohort analysis of data from the Osteoarthritis Initiative.

    PubMed

    Hafezi-Nejad, N; Guermazi, A; Roemer, F W; Eng, J; Zikria, B; Demehri, S

    2016-04-01

    To determine the association between the long-term use of analgesics and progression of osteoarthritis (OA) as evidenced by up to 3-years follow-up worsening of radiographic Kellgren-Lawrence (KL) grade and incidence of knee replacement (KR). Using nearest neighbor matching of the propensity scores with caliper in the Osteoarthritis Initiative (OAI) cohort, 173 index (Analgesic +) and 173 referent (Analgesic -) subjects were included. Analgesic + and - subjects had analgesics in all and none of their visits, respectively. Analgesic + and - subjects were balanced in their demographics, baseline, first, second and third year body mass index (BMI), Western Ontario and McMaster (WOMAC) total score, Physical and Mental health summary scales (SF-12), Physical Activity Scale for the Elderly (PASE) and Charleston Comorbidity Scale. Analgesic + and - subjects were also matched for baseline radiographic KL grade. Interval increase in the KL grade and incidence of KR were defined as the outcome. Included subjects had average 6.5 years of follow-up. By the third year, 44 subjects had an interval increase in the KL grade; 29 in Analgesic + and 15 among Analgesic - subjects (P = 0.024). By the eighth-year, 41 subjects had their first KR; 29 in Analgesic + and 12 among Analgesic - subjects (P = 0.005). Hazard Ratio (HR) of OA progression and KR for Analgesic + subjects was 1.91 (1.02-3.57) and 2.57 (1.31-5.04), respectively. Long-term use of analgesics may be associated with radiographic progression of knee OA and increased risk of future KR. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  14. Gastrointestinal nematode infections in small ruminants under the traditional husbandry system during the dry season in southern Ethiopia.

    PubMed

    Abebe, Rahmeto; Gebreyohannes, Mebrahtu; Mekuria, Solomon; Abunna, Fufa; Regassa, Alemayehu

    2010-08-01

    A cross-sectional study was conducted from November 2008 to February 2009 to investigate the prevalence and intensity of infection and risk factors of gastrointestinal (GI) nematodes in small ruminants kept under the traditional husbandry system in two districts in southern Ethiopia. Faecal samples collected from a total of 510 small ruminants (284 sheep and 226 goats) and analysed by a modified McMaster technique revealed that 222 animals (43.5%) were found to be infected with one or more GI nematodes. Five identical genera of nematodes were found in both sheep and goats, which in order of predominance were Haemonchus (56.3%), Trichostrongylus (39.6%), Oesophagostomum (22.9%), Trichuris (21.6%) and Bunostomum (10.4%). No significant (p > 0.05) differences were observed between sheep and goats proportions except for Trichuris (p < 0.05). In both sheep and goats, most of the animals were heavily infected showing faecal egg counts (FECs) above 1,200 epg. Sheep had a significantly (p < 0.05) higher mean FEC than goats. In sheep and goats, both the prevalence of GI nematodes and mean FEC were significantly (p < 0.001) associated with body condition score and faecal consistency but not with district, sex and age (p > 0.05 for each factor). In conclusion, the observation of a strong association of GI nematodes with poor body condition coupled with heavy intensity of infection in the majority of infected animals and an abundance of nematode genera of widespread economic and pathological significance warrants the institution of appropriate control measures that should necessarily include improvement of the nutritional status of the animals.

  15. Factors Influencing Radiology Residents' Fellowship Training and Practice Preferences in Canada.

    PubMed

    Mok, Philip S; Probyn, Linda; Finlay, Karen

    2016-05-01

    The study aimed to examine the postresidency plans of Canadian radiology residents and factors influencing their fellowship choices and practice preferences, including interest in teaching and research. Institutional ethics approval was obtained at McMaster University. Electronic surveys were sent to second to fifth-year residents at all 16 radiology residency programs across Canada. Each survey assessed factors influencing fellowship choices and practice preferences. A total of 103 (31%) Canadian radiology residents responded to the online survey. Over 89% from English-speaking programs intended to pursue fellowship training compared to 55% of residents from French-speaking programs. The most important factors influencing residents' decision to pursue fellowship training were enhanced employability (46%) and personal interest (47%). Top fellowship choices were musculoskeletal imaging (19%), body imaging (17%), vascular or interventional (14%), neuroradiology (8%), and women's imaging (7%). Respondents received the majority of their fellowship information from peers (68%), staff radiologists (61%), and university websites (58%). Approximately 59% planned on practicing at academic institutions and stated that lifestyle (43%), job prospects (29%), and teaching opportunities (27%) were the most important factors influencing their decisions. A total of 89% were interested in teaching but only 46% were interested in incorporating research into their future practice. The majority of radiology residents plan on pursuing fellowship training and often receive their fellowship information from informal sources such as peers and staff radiologists. Fellowship directors can incorporate recruitment strategies such as mentorship programs and improving program websites. There is a need to increase resident participation in research to advance the future of radiology. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  16. Relationship of unilateral total hip arthroplasty (THA) to contralateral and ipsilateral knee joint degeneration - a longitudinal 3T MRI study from the Osteoarthritis Initiative (OAI).

    PubMed

    Jungmann, P M; Nevitt, M C; Baum, T; Liebl, H; Nardo, L; Liu, F; Lane, N E; McCulloch, C E; Link, T M

    2015-07-01

    To evaluate the association of prevalent unilateral total hip arthroplasty (THA) with worsening of degenerative knee abnormalities and clinical outcomes in the ipsilateral and contralateral knee. Both knees of 30 individuals in the Osteoarthritis Initiative (OAI) with unilateral THA (n = 14 left, n = 16 right) at baseline were assessed at baseline and at 4-year follow-up for Whole-organ MR Imaging Scores (WORMS), cartilage T2 relaxation times (only available for right knees), Western Ontario and McMasters Universities Arthritis Index (WOMAC) scores and upper leg isometric strength. Right knees of 30 individuals without THA were analyzed as controls. Contralateral knees were compared to ipsilateral knees with paired t-tests and to control knees with multivariate regression analysis adjusting for covariates. In paired analyses, compared to ipsilateral knees, contralateral knees had higher WORMS total (P = 0.008) and cartilage scores (P = 0.007) at baseline. Over 4 years contralateral knees worsened more on WORMS total score (P = 0.008). Cartilage T2 values were higher in knees contralateral to the THA (baseline, P = 0.02; follow-up, P < 0.001). Contralateral knees had greater declines in knee extension strength (P = 0.04) and had a trend for greater worsening in WOMAC pain, stiffness, function and total scores (P = 0.04-0.09). Similar results were found comparing contralateral knees with control knees in multivariate regression models. Prevalent unilateral THA is associated with an greater progression of degenerative findings for the knee contralateral to THA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  17. Tissue structure modification in knee osteoarthritis by use of joint distraction: an open 1-year pilot study

    PubMed Central

    Intema, Femke; Van Roermund, Peter M; Marijnissen, Anne C A; Cotofana, Sebastian; Eckstein, Felix; Castelein, Rene M; Bijlsma, Johannes W J; Mastbergen, Simon C; Lafeber, Floris P J G

    2011-01-01

    Background Modification of joint tissue damage is challenging in late-stage osteoarthritis (OA). Few options are available for treating end-stage knee OA other than joint replacement. Objectives To examine whether joint distraction can effectively modify knee joint tissue damage and has the potential to delay prosthesis surgery. Methods 20 patients (<60 years) with tibiofemoral OA were treated surgically using joint distraction. Distraction (∼5 mm) was applied for 2 months using an external fixation frame. Tissue structure modification at 1 year of follow-up was evaluated radiographically (joint space width (JSW)), by MRI (segmentation of cartilage morphology) and by biochemical markers of collagen type II turnover, with operators blinded to time points. Clinical improvement was evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analogue Scale (VAS) pain score. Results Radiography demonstrated an increase in mean and minimum JSW (2.7 to 3.6 mm and 1.0 to 1.9 mm; p<0.05 and <0.01). MRI revealed an increase in cartilage thickness (2.4 to 3.0 mm; p<0.001) and a decrease of denuded bone areas (22% to 5%; p<0.001). Collagen type II levels showed a trend towards increased synthesis (+103%; p<0.06) and decreased breakdown (−11%; p<0.08). The WOMAC index increased from 45 to 77 points, and VAS pain decreased from 73 to 31 mm (both p<0.001). Conclusions Joint distraction can induce tissue structure modification in knee OA and could result in clinical benefit. No current treatment is able to induce such changes. Larger, longer and randomised studies on joint distraction are warranted. PMID:21565898

  18. Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee.

    PubMed

    van der Esch, M; Steultjens, M; Harlaar, J; Knol, D; Lems, W; Dekker, J

    2007-06-15

    To test the hypotheses that poor knee joint proprioception is related to limitations in functional ability, and poor proprioception aggravates the impact of muscle weakness on limitations in functional ability in osteoarthritis (OA) of the knee. Sixty-three patients with symptomatic OA of the knee were tested. Proprioceptive acuity was assessed by establishing the joint motion detection threshold (JMDT) in the anteroposterior direction. Muscle strength was measured using a computer-driven isokinetic dynamometer. Functional ability was assessed by the 100-meter walking test, the Get Up and Go (GUG) test, and the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC-PF) questionnaire. Correlation analyses were performed to assess the relationship between proprioception, muscle strength, and functional ability. Regression analyses were performed to assess the impact of proprioception on the relationship between muscle strength and functional ability. Poor proprioception (high JMDT) was related to more limitation in functional ability (walking time r = 0.30, P < 0.05; GUG time r = 0.30, P < 0.05; WOMAC-PF r = 0.26, P <0.05). In regression analyses, the interaction between proprioception and muscle strength was significantly related to functional ability (walking time, P < 0.001 and GUG time, P < 0.001) but not to WOMAC-PF score (P = 0.625). In patients with poor proprioception, reduction of muscle strength was associated with more severe deterioration of functional ability than in patients with accurate proprioception. Patients with poor proprioception show more limitation in functional ability, but this relationship is rather weak. In patients with poor proprioception, muscle weakness has a stronger impact on limitations in functional ability than in patients with accurate proprioception.

  19. Impact of concurrent foot pain on health and functional status in people with knee osteoarthritis: data from the osteoarthritis initiative.

    PubMed

    Paterson, Kade L; Hinman, Rana S; Hunter, David J; Wrigley, Tim V; Bennell, Kim L

    2015-07-01

    To document the prevalence of foot pain and foot pain laterality in people with knee osteoarthritis (OA) and to examine its impact on health and function. Participants from the Progression subcohort (n = 1,255, ages 45-79 years) of the Osteoarthritis Initiative with symptomatic tibiofemoral knee OA were included. Prevalence of foot pain, defined as pain in the foot/ankle, and foot pain laterality were determined. Health status was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index, the Short Form-12 Health Survey, and the Center for Epidemiological Studies Depression Scale. Function was assessed using the 20-meter walk test (WT) and a repeated chair stand test. Differences in health and functional measures were compared between groups with and without foot pain using multivariate analysis of covariance. One-fourth (n = 317 [25%]) of people with knee OA experienced concurrent foot pain, with the majority (n = 174 [55%]) reporting pain in both feet. After adjusting for covariates, people with foot pain scored worse on all health measures and on the 20-meter WT, compared to those without (P < 0.05). Differences in health and function were found between the bilateral and ipsilateral foot pain groups compared to those without foot pain (P < 0.05), but no differences were found with the contralateral group. Foot pain is common in people with knee OA, and bilateral and ipsilateral foot pain adversely affect health and function, suggesting laterality is important. Further research is needed to establish the mechanism and interaction of pathology at these sites and to evaluate foot pain treatment in this population. © 2015, American College of Rheumatology.

  20. Concurrent foot pain is common in people with knee osteoarthritis and impacts health and functional status: data from the Osteoarthritis Initiative

    PubMed Central

    Paterson, Kade L; Hinman, Rana S; Hunter, David J; Wrigley, Tim V; Bennell, Kim L

    2015-01-01

    Objective To document the prevalence of foot pain and foot pain laterality in people with knee osteoarthritis (OA), and to examine its impact on health and function. Methods Participants from the Progression subcohort (n=1255, aged 45-79 years) of the Osteoarthritis Initiative with symptomatic tibiofemoral knee OA were included. Prevalence of foot pain, defined as pain in the foot/ankle, and foot pain laterality was determined. Health status was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index, the Short Form-12 and the Centre for Epidemiological Studies Depression Scale. Function was assessed using the 20-meter walk test (20MWT) and a repeated chair stand test. Differences in health and functional measures were compared between groups with and without foot pain using multivariate analysis of covariance. Results One quarter (n=317, 25%) of people with knee OA experienced concurrent foot pain, with the majority (n=174, 55%) reporting pain in both feet. After adjusting for covariates, people with foot pain scored worse on all health measures and on the 20MWT compared to those without (p<0.05). Differences in health and function were found between the bilateral and ispilateral foot pain groups compared to those without foot pain (p<0.05), however no differences were found with the contralateral group. Conclusion Foot pain is common in people with knee OA, and bilateral and ipsilateral foot pain adversely affects health and function suggesting laterality is important. Further research is needed to establish the mechanism and interaction of pathology at these sites, and to evaluate foot pain treatment in this population. PMID:25581254

  1. Clinical Outcome of Medial Pivot Compared With Press-Fit Condylar Sigma Cruciate-Retaining Mobile-Bearing Total Knee Arthroplasty.

    PubMed

    Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik

    2017-10-01

    The purpose of this study was to compare the long-term clinical results, radiographic results, range of knee motion, patient satisfaction, and the survival rate of Medial-Pivot posterior cruciate-substituting, knee prosthesis and a press-fit condylar (PFC) Sigma cruciate-retaining mobile-bearing knee prosthesis in the same patients. One hundred eighty-two patients received Medial-Pivot knee prosthesis in one knee and a PFC Sigma knee prosthesis in the contralateral knee. The minimum duration of follow-up was 11 years (range, 11-12.6 years). The knees with a Medial-Pivot knee prosthesis had significantly worse results than those with a PFC Sigma knee prosthesis at the final follow-up with regard to the mean postoperative Knee Society knee scores (90 compared with 95 points), Western Ontario and McMaster Universities Osteoarthritis Index score (25 compared with 18 points), and range of knee motion (117° compared with 128°). Patients were more satisfied with PFC Sigma knee prosthesis (93%) than with Medial-Pivot knee prosthesis (75%). Complication rates were significantly higher in the Medial-Pivot knee group (26%) than those in the PFC Sigma knee group (6.5%). Radiographic results and survival rates (99% compared with 99.5%) were similar between the 2 groups. Although the long-term fixation and survival rate of both Medial-Pivot and PFC Sigma prostheses were similar, we observed a worse knee score, worse range of knee motion, and patient satisfaction was less in the Medial-Pivot knee group than in the PFC Sigma knee group. Furthermore, complication rate was also higher in the Medial-Pivot knee group than the other group. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment: a randomized controlled trial.

    PubMed

    Bennell, Kim L; Kyriakides, Mary; Metcalf, Ben; Egerton, Thorlene; Wrigley, Tim V; Hodges, Paul W; Hunt, Michael A; Roos, Ewa M; Forbes, Andrew; Ageberg, Eva; Hinman, Rana S

    2014-04-01

    To compare the effects of neuromuscular exercise (NEXA) and quadriceps strengthening (QS) on the knee adduction moment (an indicator of mediolateral distribution of knee load), pain, and physical function in patients with medial knee joint osteoarthritis (OA) and varus malalignment. One hundred patients with medial knee pain, mostly moderate-to-severe radiographic medial knee OA, and varus malalignment were randomly allocated to one of two 12-week exercise programs. Each program involved 14 individually supervised exercise sessions with a physiotherapist plus a home exercise component. Primary outcomes were peak external knee adduction moment (3-dimensional gait analysis), pain (visual analog scale), and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index). Eighty-two patients (38 [76%] of 50 in the NEXA group and 44 [88%] of 50 in the QS group) completed the trial. There was no significant between-group difference in the change in the peak knee adduction moment (mean difference 0.13 Nm/[body weight × height]% [95% confidence interval (95% CI) -0.08, 0.33]), pain (mean difference 2.4 mm [95% CI -6.0, 10.8]), or physical function (mean difference -0.8 units [95% CI -4.0, 2.4]). Neither group showed a change in knee moments following exercise, whereas both groups showed similar significant reductions in pain and improvement in physical function. Although comparable improvements in clinical outcomes were observed with both neuromuscular and quadriceps strengthening exercise in patients with moderate varus malalignment and mostly moderate-to-severe medial knee OA, these forms of exercise did not affect the knee adduction moment, a key predictor of structural disease progression. Copyright © 2014 by the American College of Rheumatology.

  3. Group physical therapy for veterans with knee osteoarthritis: study design and methodology.

    PubMed

    Allen, Kelli D; Bongiorni, Dennis; Walker, Tessa A; Bartle, John; Bosworth, Hayden B; Coffman, Cynthia J; Datta, Santanu K; Edelman, David; Hall, Katherine S; Hansen, Gloria; Jennings, Caroline; Lindquist, Jennifer H; Oddone, Eugene Z; Senick, Margaret J; Sizemore, John C; St John, Jamie; Hoenig, Helen

    2013-03-01

    Physical therapy (PT) is a key component of treatment for knee osteoarthritis (OA) and can decrease pain and improve function. Given the expected rise in prevalence of knee OA and the associated demand for treatment, there is a need for models of care that cost-effectively extend PT services for patients with this condition. This manuscript describes a randomized clinical trial of a group-based physical therapy program that can potentially extend services to more patients with knee OA, providing a greater number of sessions per patient, at lower staffing costs compared to traditional individual PT. Participants with symptomatic knee OA (n = 376) are randomized to either a 12-week group-based PT program (six 1 h sessions, eight patients per group, led by a physical therapist and physical therapist assistant) or usual PT care (two individual visits with a physical therapist). Participants in both PT arms receive instruction in an exercise program, information on joint care and protection, and individual consultations with a physical therapist to address specific functional and therapeutic needs. The primary outcome is the Western Ontario and McMasters Universities Osteoarthritis Index (self-reported pain, stiffness, and function), and the secondary outcome is the Short Physical Performance Test Protocol (objective physical function). Outcomes are assessed at baseline and 12-week follow-up, and the primary outcome is also assessed via telephone at 24-week follow-up to examine sustainability of effects. Linear mixed models will be used to compare outcomes for the two study arms. An economic cost analysis of the PT interventions will also be conducted. Published by Elsevier Inc.

  4. Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.

    PubMed

    Fitzgerald, G K; Fritz, J M; Childs, J D; Brennan, G P; Talisa, V; Gil, A B; Neilson, B D; Abbott, J H

    2016-08-01

    (1) Do treatment effects differ between participants receiving manual therapy (MT) with exercise compared to subjects who don't, (2) are treatment effects sustained better when participants receive booster sessions compared to those who don't over a one year period in subjects with knee osteoarthritis (KOA)? Multi-center, 2 × 2 factorial randomized clinical trial. 300 participants with knee OA were randomized to four groups: exercise-no boosters (Ex), exercise-with boosters (Ex+B), manual therapy+exercise-no boosters (MT+Ex), manual therapy+exercise-with boosters (MT+Ex+B). The primary outcome was the Western Ontario and McMaster osteoarthritis index (WOMAC) at 1 year. Secondary outcomes included knee pain, physical performance tests, and proportions of participants meeting treatment responder criteria. There were no differences between groups on the WOMAC at 1 year or on any performance-based measures. Secondary analyses indicated a) better scores on the WOMAC and greater odds of being a treatment responder at 9 weeks for participants receiving MT, b) greater odds of being a treatment responder at 1 year for participants receiving boosters. Exploratory interaction analysis suggested knee pain decreases for participants receiving boosters and increases for participants not receiving boosters from 9 weeks to 1 year. MT or use of boosters with exercise did not result in additive improvement in the primary outcome at 1 year. Secondary outcomes suggest MT may have some short term benefit, and booster sessions may improve responder status and knee pain at 1 year. However, the role of booster sessions remains unclear in sustaining treatment effects and warrants further study. gov (NCT01314183). Copyright © 2016 Osteoarthritis Research Society International. All rights reserved.

  5. The association of exposure to the 2009 south war with the physical, psychological, and family well-being of Saudi children.

    PubMed

    El Hatw, Mohamed M; El Taher, Aly A; El Hamidi, Ahmed; Alturkait, Fawziyah A

    2015-01-01

    To evaluate the nutritional, psychological, behavioral, family adjustment, and psychiatric assessment of Saudi children exposed to the 2009-2010 Jazan war. This retrospective cohort study was conducted in Saudi Arabia in July 2010. One hundred and eighty-six children exposed to the South war in Jazan, and 157 unexposed children in King Khaled Military City, Hafr Al Batin were studied for evidence of malnutrition using physical measures, evaluating psychological problems using the Child Behavior Inventory, behavioral problems using the Rutter Scale A2, family adjustment using the McMaster Family adjustment device, and for psychiatric disorders. The association of different socioeconomic variables with the psychological outcome of the exposed group was also studied. The exposed children were well nourished, had more anxiety (p=0.044), better adaptation (p<0.001), less aggression (p=0.025), less deviant behavior (p=0.007), better family adjustment and had more post traumatic stress disorder, generalized anxiety, nightmares, and grief reaction. In the exposed children, females had more anxiety (p=0.006), and males had more antisocial behavior (p=0.02). Older children had less deviant behavior (p=0.005), better adaptation (p=0.007) and better planful behavior (p<0.001). Children of elder mothers had better planful behavior (p=0.039). Children from bigger families were less aggressive (p=0.049), and had less antisocial behavior (p=0.04). This study found that children exposed to the Jazan war had more anxiety. Unexpectedly they were well nourished and had higher adaptation, lower antisocial behavior, and better family adjustment. The socioeconomic status was associated with the psychological outcome. 

  6. The association of exposure to the 2009 south war with the physical, psychological, and family well-being of Saudi children

    PubMed Central

    Hatw, Mohamed M. El; Taher, Aly A. El; Hamidi, Ahmed El; Alturkait, Fawziyah A.

    2015-01-01

    Objectives: To evaluate the nutritional, psychological, behavioral, family adjustment, and psychiatric assessment of Saudi children exposed to the 2009-2010 Jazan war. Methods: This retrospective cohort study was conducted in Saudi Arabia in July 2010. One hundred and eighty-six children exposed to the South war in Jazan, and 157 unexposed children in King Khaled Military City, Hafr Al Batin were studied for evidence of malnutrition using physical measures, evaluating psychological problems using the Child Behavior Inventory, behavioral problems using the Rutter Scale A2, family adjustment using the McMaster Family adjustment device, and for psychiatric disorders. The association of different socioeconomic variables with the psychological outcome of the exposed group was also studied. Results: The exposed children were well nourished, had more anxiety (p=0.044), better adaptation (p<0.001), less aggression (p=0.025), less deviant behavior (p=0.007), better family adjustment and had more post traumatic stress disorder, generalized anxiety, nightmares, and grief reaction. In the exposed children, females had more anxiety (p=0.006), and males had more antisocial behavior (p=0.02). Older children had less deviant behavior (p=0.005), better adaptation (p=0.007) and better planful behavior (p<0.001). Children of elder mothers had better planful behavior (p=0.039). Children from bigger families were less aggressive (p=0.049), and had less antisocial behavior (p=0.04). Conclusion: This study found that children exposed to the Jazan war had more anxiety. Unexpectedly they were well nourished and had higher adaptation, lower antisocial behavior, and better family adjustment. The socioeconomic status was associated with the psychological outcome. PMID:25630008

  7. Normalized knee-extension strength or leg-press power after fast-track total knee arthroplasty: which measure is most closely associated with performance-based and self-reported function?

    PubMed

    Aalund, Peter K; Larsen, Kristian; Hansen, Torben B; Bandholm, Thomas

    2013-02-01

    To investigate which of the 2 muscle-impairment measures for the operated leg, normalized knee extension strength or leg press power, was most closely associated with performance-based and self-reported measures of function shortly after total knee arthroplasty (TKA). Cross-sectional, exploratory study. Laboratory at a regional hospital. Individuals (N=39) with an average age ± SD of 65.5±10.3 years, who all had unilateral TKA 28 days prior. None. The patients performed maximal isometric knee extensions and dynamic leg presses to determine their body-mass normalized knee extension strength and leg press power, respectively. The 10-meter fast speed walking- and 30-second chair stand tests were used to determine performance-based function, while the Western Ontario and McMaster Universities Osteoarthritis Index and Oxford Knee Scores were used to determine self-reported function. Normalized leg press power was more closely associated with both performance-based (r=.82, P<.001) and self-reported (r=.48, P=.002) measures of function compared with normalized knee extension strength (r=.51, P=.001 and r=.39, P=.015, respectively). Normalized leg press power was more closely associated with both performance-based and self-reported function early after TKA than normalized knee extension strength. It may be explained by the fact that performance-based measures of function are typically closed kinetic chain tasks, such as walking or rising from a chair, and self-reported measures of function typically include questions that address perceived difficulty with performing these same tasks. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Civamide cream 0.075% in patients with osteoarthritis of the knee: a 12-week randomized controlled clinical trial with a longterm extension.

    PubMed

    Schnitzer, Thomas J; Pelletier, Jean-Pierre; Haselwood, Doug M; Ellison, William T; Ervin, John E; Gordon, Richard D; Lisse, Jeffrey R; Archambault, W Tad; Sampson, Allan R; Fezatte, Heidi B; Phillips, Scott B; Bernstein, Joel E

    2012-03-01

    To evaluate the safety and efficacy of civamide cream 0.075% for the treatment of osteoarthritis (OA) of the knee. We conducted a 12-week, multicenter, randomized, double-blind study with a 52-week open-label extension. Patients with OA of the knee received either civamide cream 0.075% or a lower dose of civamide cream, 0.01%, as the control. The 3 co-primary endpoints in the double-blind study were the time-weighted average (TWA) of change from baseline to Day 84 in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale, the WOMAC physical function subscale, and the Subject Global Evaluation (SGE). In the 52-week open-label extension study, the Osteoarthritis Pain Score and SGE were assessed. A total of 695 patients were randomized to receive civamide cream 0.075% (n = 351) or civamide cream 0.01% (control; n = 344) in the double-blind study. Significance in favor of civamide cream 0.075% was achieved for the TWA for all 3 co-primary efficacy variables: WOMAC pain (p = 0.009), WOMAC physical function (p < 0.001), and SGE (p = 0.008); and at Day 84 for these 3 variables (p = 0.013, p < 0.001, and p = 0.049, respectively). These analyses accounted for significant baseline-by-treatment interactions. In the 52-week open-label extension, efficacy was maintained. Civamide cream 0.075% was well tolerated throughout the studies. These studies demonstrate the efficacy of civamide cream for up to 1 year of continuous use. Civamide cream, with its lack of systemic absorption, does not have the potential for serious systemic toxicity, in contrast to several other OA treatments.

  9. Virtual reality exercise improves mobility after stroke: an inpatient randomized controlled trial.

    PubMed

    McEwen, Daniel; Taillon-Hobson, Anne; Bilodeau, Martin; Sveistrup, Heidi; Finestone, Hillel

    2014-06-01

    Exercise using virtual reality (VR) has improved balance in adults with traumatic brain injury and community-dwelling older adults. Rigorous randomized studies regarding its efficacy, safety, and applicability with individuals after stroke are lacking. The purpose of this study was to determine whether an adjunct VR therapy improves balance, mobility, and gait in stroke rehabilitation inpatients. A blinded randomized controlled trial studying 59 stroke survivors on an inpatient stroke rehabilitation unit was performed. The treatment group (n=30) received standard stroke rehabilitation therapy plus a program of VR exercises that challenged balance (eg, soccer goaltending, snowboarding) performed while standing. The control group (n=29) received standard stroke rehabilitation therapy plus exposure to identical VR environments but whose games did not challenge balance (performed in sitting). VR training consisted of 10 to 12 thirty-minute daily sessions for a 3-week period. Objective outcome measures of balance and mobility were assessed before, immediately after, and 1 month after training. Confidence intervals and effect sizes favored the treatment group on the Timed Up and Go and the Two-Minute Walk Test, with both groups meeting minimal clinical important differences after training. More individuals in the treatment group than in the control group showed reduced impairment in the lower extremity as measured by the Chedoke McMaster Leg domain (P=0.04) immediately after training. This VR exercise intervention for inpatient stroke rehabilitation improved mobility-related outcomes. Future studies could include nonambulatory participants as well as the implementation strategies for the clinical use of VR. http://www.ANZCTR.org.au/. Unique identifier: ACTRN12613000710729. © 2014 American Heart Association, Inc.

  10. Vitamin D supplementation for the management of knee osteoarthritis: a systematic review of randomized controlled trials.

    PubMed

    Hussain, Salman; Singh, Ambrish; Akhtar, Mohd; Najmi, Abul Kalam

    2017-09-01

    Conflicting evidence exists concerning the supplementation of vitamin D in knee osteoarthritis condition. This systematic literature review was done to explore the effects of vitamin D supplementation in the management of knee osteoarthritis. Electronic literature search was done in databases like PubMed ® , Embase ® , and Cochrane CENTRAL from inception to 6th July 2016. The quality of included Randomized Controlled Trials (RCTs) was assessed using Cochrane risk of bias tool. We considered change in Western Ontario and McMaster Universities (WOMAC) index, Visual Analog Scale (VAS) and Functional Pain Score (FPS) as the primary outcome measure. Change in tibial cartilage thickness, joint space width and safety profile was considered as secondary outcomes. Participants were randomized either to treatment or placebo group. Participants received cholecalciferol as an intervention through oral route in the dose range of 800-60,000 IU except in the one study where participants received ergocalciferol. All included RCTs showed a significant increase in serum vitamin D level in the treatment group compared to the placebo group at the end point. No significant reduction in pain and function was reported on WOMAC scale except in one study. No significant difference was reported for WOMAC stiffness in any study. VAS was assessed in three studies in which two showed statistically significant improvement in knee pain. Three of the RCTs reported safety data with one incidence of calculus ureteric and hip fracture found to be related to the drug. The study found evidence from RCTs to be insufficient to support the use of vitamin D supplementation for patients with knee osteoarthritis.

  11. Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis.

    PubMed

    Ogata, Toru; Ideno, Yuki; Akai, Masami; Seichi, Atsushi; Hagino, Hiroshi; Iwaya, Tsutomu; Doi, Toru; Yamada, Keiko; Chen, Ai-Zhen; Li, Yingzi; Hayashi, Kunihiko

    2018-04-30

    Osteoarthritis (OA) of the knee is one of the main causes of mobility decline in the elderly. Non-surgical treatments such as administration of supplements to strengthen the joint cartilage matrix have become popular not only for pain relief but also for joint preservation. Glucosamine has been used in many countries based on the increasing evidence of its effectiveness for OA. Although there are many previous studies and systematic reviews, the findings vary and different conclusions have been drawn. We aimed to review recent randomized controlled trials on glucosamine for knee OA to reveal up-to-date findings about this supplement. We also performed a meta-analysis of some of the outcomes to overcome the unsolved bias in each study. Eighteen articles written between 2003 and 2016 were analyzed. Many used visual analogue scale (VAS) pain scores and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which were assessed in our meta-analysis. We found a marginally favorable effect of glucosamine on VAS pain scores. The effect on knee function, as measured by the WOMAC, was small and not significant. A newly established knee OA scale, the Japanese Knee Osteoarthritis Measure (JKOM), is commonly used in Japan. Although the number of subjects was small, the JKOM meta-analysis indicated that glucosamine is superior to a placebo in alleviating knee OA symptoms. Given this, we concluded that glucosamine has the potential to alleviate knee OA pain. Further studies are needed to evaluate the effect of glucosamine on knee function and joint preservation, as well as to evaluate the combined effect with other components, such as chondroitin.

  12. Measuring the impact and distress of osteoarthritis from the patients' perspective

    PubMed Central

    Pallant, Julie F; Keenan, Anne-Maree; Misajon, Roseanne; Conaghan, Philip G; Tennant, Alan

    2009-01-01

    Background To assess the internal construct validity of the Perceived Impact of Problem Profile (PIPP), a patient based outcome measure based on the International Classification of Functioning, Disability and Health (ICF), which assesses impact and distress, in an osteoarthritis (OA) cohort. Methods A questionnaire comprising the 23-item PIPP, which assesses five domains (mobility, participation, self care, psychological well being and relationships), the Western Ontario McMasters University Osteoarthritis Index (WOMAC), the General Well-Being Index (GWBI), and the Hospital Anxiety and Depression Scale (HADS) was posted to people with clinician diagnosed OA. Assessment of the internal construct validity of the PIPP was undertaken using Rasch analysis performed with RUMM2020 software and concurrent validity through comparator measures. Results Two hundred and fifty-nine participants with OA responded. Analysis of the five individual domains of the PIPP indicated that there was good fit to the Rasch model, with high person separation reliability. One item required removal from the Mobility subscale and the Participation subscale. There were strong correlations between the PIPP Mobility scores and the WOMAC disability and pain subscales (rho = .73 and rho = .68), and between the PIPP Psychological well-being and HADS Depression (rho = .71) and GWBI (rho = -.69). High inter-correlations between the impact and distress subscales for each domain (range rho = .85 to .96), suggested redundancy of the latter. Conclusion This study demonstrates that the PIPP has good psychometric properties in an OA population. The PIPP, using just the impact subscales, provides a brief, reliable and valid means of assessing the impact of OA from the individual's perspective and operationalizing the bio-psychosocial model by the application of a single multi-domain questionnaire. PMID:19400966

  13. Efficacy of Hip Strengthening Exercises Compared With Leg Strengthening Exercises on Knee Pain, Function, and Quality of Life in Patients With Knee Osteoarthritis.

    PubMed

    Lun, Victor; Marsh, Andrew; Bray, Robert; Lindsay, David; Wiley, Preston

    2015-11-01

    The purpose of this study was to compare the efficacy of hip and leg strengthening exercise programs on knee pain, function, and quality of life (QOL) of patients with knee osteoarthritis (KOA). Single-Blinded Randomized Clinical Trial. Patients with KOA. Male and female subjects were recruited from patients referred to the University of Calgary Sport Medicine Center and from newspaper advertisements. Thirty-seven and 35 patients with KOA were randomly assigned to either a 12-week hip or leg strengthening exercise program, respectively. Both exercise programs consisted of strengthening and flexibility exercises, which were completed 3 to 5 days a week. The first 3 weeks of exercise were supervised and the remaining 9 weeks consisted of at-home exercise. Knee Injury and Osteoarthritis Score (KOOS) and Western Ontario McMaster Arthritis Index (WOMAC) questionnaires, 6-minute walk test, hip and knee range of motion (ROM), and hip and leg muscle strength. Statistically and clinically significant improvements in the KOOS and WOMAC pain subscale scores were observed in both the hip and leg strengthening programs. There was no statistical difference in the change in scores observed between the 2 groups. Equal improvements in the KOOS and WOMAC function and QOL subscales were observed for both programs. There was no change in hip and knee ROM or hip and leg strength in either group. Isolated hip and leg strengthening exercise programs seem to similarly improve knee pain, function, and QOL in patients with KOA. The results of this study show that both hip and leg strengthening exercises improve pain and QOL in patients with KOA and should be incorporated into the exercise prescription of patients with KOA.

  14. Study protocol for a randomised controlled trial of ultrasound-guided pulsed radiofrequency of the genicular nerves in the treatment of patients with osteoarthritis knee pain

    PubMed Central

    Valentí, Pedro; Hernández, Beatriz; Mir, Bartolome; Aguilar, Jose Luis

    2017-01-01

    Introduction The goals for the management of patients with osteoarthritis (OA) of the knee are to control pain and to minimise disability. Because the number of patients will increase as the population ages, alternative approaches to alleviate their joint pain other than conventional treatments are necessary. The purpose of this article is to present a refined protocol to determine if there is long-term improvement in pain and function after ultrasound-guided pulsed radiofrequency treatment of the genicular nerves (GNs) in patients with chronic painful knee OA. Methods and analysis This study is a randomised, double-blind, placebo-controlled, parallel design trial. One hundred and forty-two outpatients with OA of the knee will be recruited from Mallorca, Spain. Participants will be randomly allocated into two groups: ultrasound-guided sham GN pulsed radiofrequency without active treatment and ultrasound-guided real GN pulsed radiofrequency. The primary outcome measures will be the observed changes from baseline pain intensity based on visual analogue scale (VAS). The possible changes in the secondary efficacy variables from the baseline as assessed by the Goldberg Anxiety and Depression Scale, pain medication use, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC subscales) and VAS pain intensity are also to be included in the study. These variables will be assessed at baseline, 1 month, 3 months, 6 months and 1 year after treatment. Ethics and dissemination The protocol was approved by the Research Ethic Committee of the Balearic Islands (IB 3223/16 PI). The results will be disseminated in peer-reviewed journals and at scientific conferences. Trial registration Trial registration numberNCT02915120; Pre-results PMID:29102985

  15. Anti-inflammatory effect as a mechanism of effectiveness underlying the clinical benefits of pelotherapy in osteoarthritis patients: regulation of the altered inflammatory and stress feedback response

    NASA Astrophysics Data System (ADS)

    Ortega, E.; Gálvez, I.; Hinchado, M. D.; Guerrero, J.; Martín-Cordero, L.; Torres-Piles, S.

    2017-10-01

    The purpose of the present investigation was to evaluate whether an anti-inflammatory effect together with an improvement of the regulation of the interaction between the inflammatory and stress responses underlies the clinical benefits of pelotherapy in osteoarthritis (OA) patients. This study evaluated the effects of a 10-day cycle of pelotherapy at the spa centre `El Raposo' (Spain) in a group of 21 OA patients diagnosed with primary knee OA. Clinical assessments included pain intensity using a visual analog scale; pain, stiffness and physical function using the Western Ontario and McMaster Universities Arthritis Index; and health-related quality of life using the EuroQol-5D questionnaire. Serum inflammatory cytokine levels (IL-1β, TNF-α, IL-8, IL-6, IL-10 and TGF-β) were evaluated using the Bio-Plex® Luminex® system. Circulating neuroendocrine-stress biomarkers, such as cortisol and extracellular 72 kDa heat shock protein (eHsp72), were measured by ELISA. After the cycle of mud therapy, OA patients improved the knee flexion angle and OA-related pain, stiffness and physical function, and they reported a better health-related quality of life. Serum concentrations of IL-1β, TNF-α, IL-8, IL-6 and TGF-β, as well as eHsp72, were markedly decreased. Besides, systemic levels of cortisol increased significantly. These results confirm that the clinical benefits of mud therapy may well be mediated, at least in part, by its systemic anti-inflammatory effects and neuroendocrine-immune regulation in OA patients. Thus, mud therapy could be an effective alternative treatment in the management of OA.

  16. Associations of Varus Thrust and Alignment with Pain in Knee Osteoarthritis

    PubMed Central

    Lo, Grace H.; Harvey, William F.; McAlindon, Timothy E.

    2012-01-01

    Objective To compare associations of varus thrust and varus static alignment with pain in those with knee osteoarthritis (OA). Method This was a cross-sectional study of participants from a randomized controlled trial of vitamin D for knee OA. Participants were video recorded walking and scored for presence of varus thrust. Standard PA knee X-rays were measured for static alignment. Pain questions from the Western Ontario McMasters Osteoarthritis (WOMAC) questionnaire assessed symptoms. We calculated means for total WOMAC pain by varus thrust and varus alignment (i.e. corrected anatomic alignment < 178°). We performed ordinal logistic regressions; outcomes: individual WOMAC pain questions; predictors: varus thrust and varus alignment. Results There were 82 participants, mean age 65.1 (±8.5), mean body mass index 30.2 (±5.4), and 60% female. Total WOMAC pain was 6.3 versus 3.9, p = 0.007 in those with versus without definite varus thrust. For varus alignment, total WOMAC pain was 5.2 versus 4.2, p = 0.30. Odds ratios for pain with walking and standing were 5.5 (95%CI 2.0 – 15.1) and 6.0 (95%CI 2.2 – 16.2) in those with versus without definite varus thrust. There were no significant associations between varus alignment and individual WOMAC pain questions. Sensitivity analyses suggested a more stringent definition of varus might have been associated with walking and standing pain. Conclusion In those with knee OA, varus thrust and possibly varus static alignment, were associated with pain, specifically during weight-bearing activities. Treatment of varus thrust (e.g. via bracing or gait modification) may lead to improvement of symptoms. PMID:22307813

  17. Symptom Assessment in Knee Osteoarthritis Needs to Account for Physical Activity Level

    PubMed Central

    Lo, Grace H.; McAlindon, Timothy E.; Hawker, Gillian A.; Driban, Jeffrey B.; Price, Lori Lyn; Song, Jing; Eaton, Charles B.; Hochberg, Marc C.; Jackson, Rebecca D.; Kwoh, C. Kent; Nevitt, Michael C.; Dunlop, Dorothy D.

    2015-01-01

    Objective Pain is not always correlated with radiographic osteoarthritis (OA) severity possibly because people modify activities to manage symptoms. Measures of symptoms that consider pain in the context of activity level may therefore provide greater discrimination than pain alone. Our objective was to compare discrimination of a measure of pain alone with combined measures of pain relative to physical activity across radiographic OA levels. Methods This is a cross-sectional study of the Osteoarthritis Initiative accelerometer substudy, including those with and without knee OA. Two composite pain and activity knee symptom (PAKS) scores were calculated as Western Ontario and McMaster (WOMAC) Universities Osteoarthritis Pain Scale plus one divided by physical activity measures (step and activity counts). Symptom score discrimination across Kellgren and Lawrence (KL) grades were evaluated using histograms and quantile regression. Results 1806 participants, mean age 65.1 (9.1) years, mean BMI 28.4 (4.8) kg/m2, and 55.6% female, were included. WOMAC, but not PAKS scores, exhibited a floor effect. Adjusted median WOMAC by KL grades 0 – 4 were 0, 0, 1, 1, and 3 respectively. Median PAKS1 and PAKS2 were 24.9, 26.0, 32.4, 46.1, 97.9, and 7.2, 7.2, 9.2, 12.9, 23.8, respectively. PAKS scores had more statistically significant comparisons between KL grades compared with WOMAC. Conclusions Symptom assessments incorporating pain and physical activity did not exhibit a floor effect and were better able to discriminate radiographic severity than pain alone, particularly in milder disease. Pain in the context of physical activity level should be used to assess knee OA symptoms. PMID:26407008

  18. Outcomes of total knee arthroplasty in relation to preoperative patient-reported and radiographic measures: data from the osteoarthritis initiative.

    PubMed

    Kahn, Timothy L; Soheili, Aydin; Schwarzkopf, Ran

    2013-12-01

    Total knee arthroplasty (TKA) is the preferred surgical treatment for end-stage osteoarthritis. However, substantial numbers of patients still experience poor outcomes. Consequently, it is important to identify which patient characteristics are predictive of outcomes in order to guide clinical decisions. Our hypothesis is that preoperative patient-reported outcome measures and radiographic measures may help to predict TKA outcomes. Using cohort data from the Osteoarthritis Initiative, we studied 172 patients who underwent TKA. For each patient, we compiled pre- and postoperative Western Ontario and McMaster University Arthritis Index (WOMAC) scores. Radiographs were measured for knee joint angles, femorotibial angles, anatomical lateral distal femoral angles, and anatomical medial proximal tibial angles; Kellgren and Lawrence (KL) grades were assigned to each compartment of the knee. All studied measurements were compared to WOMAC outcomes. Preoperative WOMAC disability, pain, and total scores were positively associated with postoperative WOMAC total scores (P = .010, P = .010, and P = .009, respectively) and were associated with improvement in WOMAC total scores (P < .001, P < .001, and P < .001, respectively). For radiographic measurements, preoperative joint angles were positively associated with improvements in postoperative WOMAC total scores (P = .044). Combined KL grades (medial and lateral compartments) were negatively correlated with postoperative WOMAC disability and pain scores (P = .045 and P = .044) and were positively correlated with improvements in WOMAC total scores (P = .001). All preoperative WOMAC scores demonstrated positive associations with postoperative WOMAC scores, while among the preoperative radiographic measurements only combined KL grades and joint angles showed any correlation with postoperative WOMAC scores. Higher preoperative KL grades and joint angles were associated with better (lower) postoperative WOMAC scores, demonstrating an

  19. Pulsed radiofrequency of the composite nerve supply to the knee joint as a new technique for relieving osteoarthritic pain: a preliminary report.

    PubMed

    Vas, Lakshmi; Pai, Renuka; Khandagale, Nishigandha; Pattnaik, Manorama

    2014-01-01

    We report a new technique for pulsed radiofrequency (PRF) of the entire nerve supply of the knee as an option in treating osteoarthritis (OA) of knee. We targeted both sensory and motor nerves supplying all the structures around the knee: joint, muscles, and skin to address the entire nociception and stiffness leading to peripheral and central sensitization in osteoarthritis. Ten patients with pain, stiffness, and loss of function in both knees were treated with ultrasonography (USG) guided PRF of saphenous, tibial, and common peroneal nerves along with subsartorial, peripatellar, and popliteal plexuses. USG guided PRF of the femoral nerve was also done to address the innervation of the quadriceps muscle. Assessment of pain (Numerical Rating Scale [NRS], pain DETECT, knee function [Western Ontario and McMaster Universities Osteoarthritis Index- WOMAC]) were documented pre and post PRF at 3 and 6 months. Knee radiographs (Kellgren-Lawrence [K-L] grading) were done before PRF and one week later. All the patients showed a sustained improvement of NRS, pain DETECT, and WOMAC at 3 and 6 months. The significant improvement of patellar position and tibio-femoral joint space was concordant with the patient's reporting of improvement in stiffness and pain. The sustained pain relief and muscle relaxation enabled the patients to optimize physiotherapy thereby improving endurance training to include the daily activities of life. We conclude that OA knee pain is a product of neuromyopathy and that PRF of the sensory and motor nerves appeared to be a safe, effective, and minimally invasive technique. The reduction of pain and stiffness improved the knee function and probably reduced the peripheral and central sensitization.

  20. Comparison of Customized Cutting Block and Conventional Cutting Instrument in Total Knee Arthroplasty: A Randomized Controlled Trial.

    PubMed

    Tammachote, Nattapol; Panichkul, Phonthakorn; Kanitnate, Supakit

    2018-03-01

    Customized cutting block (CCB) was designed to ensure the accurate alignment of knee prostheses during total knee arthroplasty. Given the paucity of CCB efficacy data, we compare CCB with conventional cutting guide using a randomized controlled trial. One hundred eight osteoarthritic knee patients underwent total knee arthroplasty by one experienced surgeon were randomized to receive CCB (n = 54) or conventional cutting instrument (CCI) surgery (n = 54). The primary outcomes were limb alignment, prostheses position, and operative time. The secondary outcomes were hemodynamic alteration after surgery, functional outcomes (modified Western Ontario and McMaster University Osteoarthritis Index) and range of motion at 2 years after surgery. Mean hip-knee-ankle angle in the CCB group was 179.4° ± 1.8° vs 179.1° ± 2.4° in the CCI group, Δ = 0 (95% confidence interval [CI] -0.6 to 1.1, P = .55). Mean operative time was faster in the CCB arm: 93 ± 12 vs 104 ± 12 minutes, Δ = 11 (95% CI -16.7 to -7.2, P < .0001). There were no differences in hemodynamic parameters, mean blood loss (446 [CCB] vs 514 mL [CCI], Δ = -68 [95% CI -138 to 31 mL, P = .21]), postoperative hemoglobin changes, incidence of hypotension (systolic <90 mm Hg), oliguria, and rates of blood transfusion. Functional outcomes and range of motion were also similar. There was no improvement in alignment, hemodynamic changes, blood loss, and knee functional outcomes. CCB reduced surgical time by 11 minutes in our population. CCB cost-effectiveness should be further investigated. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Predictors of Patient-Reported Outcomes of Total Joint Arthroplasty in a Developing Country.

    PubMed

    Bido, Jennifer; Yang, Ying H; Collins, Jamie E; Dong, Yan; Driscoll, Daniel A; Alcantara, Luis A; Thornhill, Thomas S; Katz, Jeffrey N

    2017-06-01

    In response to the growing burden of joint disease, developing countries are starting to create their own total joint arthroplasty (TJA) programs. To date, there has been limited research on predictors of TJA outcomes in a developing country. This investigation uses patient-reported outcome measures collected by a medical mission to assess predictors of TJA outcomes in the Dominican Republic. Baseline and postoperative information from 156 of the mission's recipients of hip and knee TJA was used. Demographics were abstracted from clinical notes, and self-reported pain and functional status were assessed using Western Ontario and McMaster University Osteoarthritis Index and Short-Form 36 measures. Bivariate analysis identified variables to include in multivariable regression models of factors associated with function and pain outcomes and improvement in these domains 1 or 2 years postoperatively. The cohort had a mean age of 61.3 years, 82% were female, 79% had total knee arthroplasty, and 42% of the procedures were bilateral. In multivariate analyses, at P < .05, male sex, better preoperative function, and use of bilateral procedure were associated with better functional outcome. Male sex and worse preoperative pain were associated with better pain outcome. Worse preoperative pain and function, as well as bilateral surgery were associated with greater improvement in function. Additionally, a greater number of bothersome joints was associated with greater pain reduction. Our findings of better follow-up pain scores among patients with worse pain preoperatively and better functional improvement among those undergoing bilateral replacements contrast with study results from developed countries. The explanations for these observations merit further study. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Formal Physical Therapy After Total Hip Arthroplasty Is Not Required: A Randomized Controlled Trial.

    PubMed

    Austin, Matthew S; Urbani, Brian T; Fleischman, Andrew N; Fernando, Navin D; Purtill, James J; Hozack, William J; Parvizi, Javad; Rothman, Richard H

    2017-04-19

    The value of formal physical therapy after total hip arthroplasty is unknown. With substantial changes that have occurred in surgical and anesthesia techniques, self-directed therapy may be efficacious in restoring function to patients undergoing total hip arthroplasty. We conducted a single-center, randomized trial of 120 patients undergoing primary, unilateral total hip arthroplasty who were eligible for direct home discharge. The experimental group followed a self-directed home exercise program for 10 weeks. The control group received the standard protocol for physical therapy that included in-home visits with a physical therapist for the first 2 weeks followed by formal outpatient physical therapy for 8 weeks. Functional outcomes were measured using validated instruments including the Harris hip score (HHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form-36 Health Survey (SF-36) preoperatively, at 1 month postoperatively, and at 6 to 12 months postoperatively. Of 120 randomized patients, 108 were included in the final analysis. Ten patients (19%) were randomized to unsupervised home exercise and 20 patients (37%) were randomized to formal outpatient therapy crossed over between groups. There was no significant difference in any of the measured functional outcomes between patients receiving formal therapy (n = 54) and those participating in unsupervised home exercise (n = 54) at any time point (HHS, p = 0.82; WOMAC, p = 0.80; and SF-36 physical health, p = 0.90). This randomized trial suggests that unsupervised home exercise is both safe and efficacious for a majority of patients undergoing total hip arthroplasty, and formal physical therapy may not be required. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

  3. How balance task-specific training contributes to improving physical function in older subjects undergoing rehabilitation following hip fracture: a randomized controlled trial.

    PubMed

    Monticone, Marco; Ambrosini, Emilia; Brunati, Roberto; Capone, Antonio; Pagliari, Giulia; Secci, Claudio; Zatti, Giovanni; Ferrante, Simona

    2018-03-01

    To evaluate the efficacy of a rehabilitation programme including balance task-specific training in improving physical function, pain, activities of daily living (ADL), balance and quality of life in subjects after a hip fracture. Randomized controlled trial. A total of 52 older subjects selected for internal fixation due to extra-capsular hip fracture were randomized to be included in an experimental ( n = 26) and control group ( n = 26). The experimental group underwent a rehabilitation programme based on balance task-specific training. The control group underwent general physiotherapy, including open kinetic chain exercises and walking training. Both groups individually followed programmes of 90-minute sessions five times/week for three weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a Pain Numerical Rating Scale, the Berg Balance Scale, the Functional Independence Measure and the 36-item Short-Form Health Survey. The participants were evaluated before and after training, and after 12 months. Significant effects of time, group and time × group were found for all outcome measures in favour of the experimental group. A clinically important between-group difference of 25 points was achieved after training and at follow-up in terms of the primary outcome (WOMAC function before treatment, after treatment and at follow-up was 84.8 (3.7), 39.8 (4.9) and 35.7 (6.2) for the experimental group and 80.9 (5.7), 65.2 (7.1) and 61.0 (11.1) for the control group). An inpatient rehabilitation programme based on balance task-specific training is useful in improving physical function, pain, ADL and quality of life in older patients after hip fracture.

  4. Cardiovascular Endurance and Heart Rate Variability in Adolescents With Type 1 or Type 2 Diabetes

    PubMed Central

    Faulkner, Melissa Spezia; Quinn, Laurie; Rimmer, James H.; Rich, Barry H.

    2006-01-01

    Background Incidence rates of both type 1 and type 2 diabetes mellitus (DM) are increasing in youth and may eventually contribute to premature heart disease in early adulthood. This investigation explored the influence of type of diabetes, gender, body mass index (BMI), metabolic control (HbA 1c ), exercise beliefs and physical activity on cardiovascular endurance (CE), and heart rate variability (HRV). Differences in exercise beliefs, physical activity, HRV, and CE in youth with type 1 versus type 2 DM were determined. Methods Adolescents with type 1 DM (n = 105) or with type 2 DM (n = 27) completed the Exercise Belief Instrument and the Physical Activity Recall. Twenty-four HRV measures were obtained via Holter monitoring and analyzed using SpaceLabs Vision Premier™ software system. The McMaster cycle test was used to measure CE (V02peak). Results Regardless of the type of DM, females and those with higher BMI, poorer metabolic control, and lower amounts of physical activity tended to have lower levels of CE. Exercise beliefs consistently predicted both frequency and time domain HRV measures. Measures of exercise beliefs, self-reported physical activity, CE (V0 2peak ), and HRV were significantly lower in adolescents with type 2 DM in comparison to those with type 1 DM. Conclusions and Recommendations Early findings of poor physical fitness, lower HRV, fewer positive beliefs about exercise, and less active lifestyles highlight the importance of developing culturally sensitive interventions for assisting youth to make lifelong changes in their physical activity routines. Females, those with poorer metabolic control, and minority youth with type 2 DM may be particularly vulnerable to later cardiovascular disease. PMID:15920000

  5. Efficacy of Triamcinolone Hexacetonide versus Methylprednisolone Acetate Intraarticular Injections in Knee Osteoarthritis: A Randomized, Double-blinded, 24-week Study.

    PubMed

    Lomonte, Andrea Barranjard Vannucci; de Morais, Marina Gonçalves Veras; de Carvalho, Lina Oliveira; Zerbini, Cristiano Augusto de Freitas

    2015-09-01

    Intraarticular (IA) corticosteroid injections are broadly used in knee osteoarthritis (OA); however, the best corticosteroid agent is not well defined. The aim of the present study was to compare the efficacy of triamcinolone hexacetonide (TH) and methylprednisolone acetate (MA) injections in knee OA. Patients with symptomatic knee OA and Kellgren-Lawrence grade II or III were randomized to receive 40 mg of IA TH or MA. Evaluations were performed at 4, 12, and 24 weeks. The primary outcome was a change in the patient's assessment of pain by visual analog scale from baseline to Week 4. Secondary outcomes included a global assessment of the disease by patients and physicians, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne index (LI), and Outcome Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) criteria of response. Generalized estimating equations were used in statistical analysis. The intention-to-treat population included 100 patients; 50 in each study arm. A significant improvement in pain was observed at Week 4 for both groups (p < 0.0001), with no difference between them (p = 0.352). This improvement was sustained up to Week 24. A significant improvement from the baseline was observed for both the patient's and the physician's global assessments, WOMAC questionnaire, and LI, with no differences between the groups. Improvements in the secondary outcomes were sustained during the study. The OMERACT-OARSI criteria of response was achieved by 74% and 72% of patients in the TH and the MA groups, respectively. Both IA therapies are equally effective, and improvement in pain and function can be sustained for up to 24 weeks. Controlled-trials.com identifier: ISRCTN15077843.

  6. Reproducibility of femoral offset following short stem and straight stem total hip arthroplasty.

    PubMed

    von Roth, Philipp; Perka, Carsten; Mayr, Hermann O; Preininger, Bernd; Ziebula, Friedrich; Matziolis, Georg; Hube, Robert

    2014-07-01

    Bone stock-preserving short stem prostheses have gained importance in total hip arthroplasty (THA) with the use of minimally invasive surgical procedures. Because of their metaphyseal fixation and their dependency on the calcar radius, it is unknown whether the femoral offset can be reproduced with the same accuracy following short stem vs standard stem THA. This study clarifies whether it is possible to restore the femoral offset using a short stem prosthesis (Fitmore; Zimmer, Warsaw, Indiana) compared with a conventional straight stem prosthesis (CLS; Zimmer) following minimally invasive implantation using an anterolateral approach. In a prospective, randomized, double-blinded study, 80 patients underwent THA using a short stem (SS group; n=40) or CLS implant (control group; n=40). Follow-up examinations were conducted 6 weeks postoperatively. Radiological and functional outcomes were measured. Subjective assessment of quality of life was evaluated using the Harris Hip Score (HHS), the Short Form 36-item health survey (SF-36), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pre- and postoperative comparison of the groups' change in offset showed no significant differences (SS group difference from pre- to postoperative, 6.1±6.5 mm; control group difference from pre- to postoperative, 6.5±7.1 mm; P=.93). Group comparison after 6 weeks revealed no significant differences in HHS, SF-36, or WOMAC. Based on these data, an equivalent reproducibility of the femoral offset was demonstrated following short stem and straight stem THA using a minimally invasive anterolateral approach. If the long-term results of short stems show a comparable survival, they represent a sensible alternative to standard stems. Copyright 2014, SLACK Incorporated.

  7. Gastrointestinal nematodes and anthelmintic resistance in Danish goat herds☆

    PubMed Central

    Holm, Signe A.; Sörensen, Camilla R. L.; Thamsborg, Stig M.; Enemark, Heidi L.

    2014-01-01

    The prevalence of gastrointestinal parasites in Danish goats and the presence of anthelmintic resistance (AR) in 10 selected herds were investigated during April–September 2012. All Danish herds (n = 137) with 10 or more adult goats were invited to participate, and of these 27 herds met the inclusion criterion of more than 10 young kids never treated with anthelmintics. Questionnaire data on management were collected, and faecal samples from 252 kids were analysed by the McMaster technique. From all herds with a mean faecal egg count (FEC) above 300 eggs per g of faeces, pooled samples were stained with peanut agglutinin (PNA) for specific detection of Haemonchus contortus. Strongyle eggs were detected with an individual prevalence of 69%, including Nematodirus battus (3.6%) and other Nematodirus species (15.0%). Eimeria spp. were observed in 99.6% of the kids. H. contortus was found in 11 of 12 (92%) tested herds. Anthelmintics were used in 89% of the herds with mean treatment frequencies of 0.96 and 0.89 treatments per year for kids and adults, respectively. In 2011, new animals were introduced into 44% of the herds of which 25% practised quarantine anthelmintic treatments. In 10 herds the presence of AR was analysed by egg hatch assay and FEC reduction tests using ivermectin (0.3 mg/kg) or fenbendazole (10.0 mg/kg). AR against both fenbendazole and ivermectin was detected in seven herds; AR against fenbendazole in one herd, and AR against ivermectin in another herd. In conclusion, resistance to the most commonly used anthelmintics is widespread in larger goat herds throughout Denmark. PMID:25076056

  8. Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain.

    PubMed

    Jessep, Sally A; Walsh, Nicola E; Ratcliffe, Julie; Hurley, Michael V

    2009-06-01

    Chronic knee pain is a major cause of disability in the elderly. Management guidelines recommend exercise and self-management interventions as effective treatments. The authors previously described a rehabilitation programme integrating exercise and self-management [Enabling Self-management and Coping with Arthritic knee Pain through Exercise (ESCAPE-knee pain)] that produced short-term improvements in pain and physical function, but sustaining these improvements is difficult. Moreover, the programme is untried in clinical environments, where it would ultimately be delivered. To establish the feasibility of ESCAPE-knee pain and compare its clinical effectiveness and costs with outpatient physiotherapy. Pragmatic, randomised controlled trial. Outpatient physiotherapy department and community centre. Sixty-four people with chronic knee pain. Outpatient physiotherapy compared with ESCAPE-knee pain. The primary outcome was physical function assessed using the Western Ontario and McMaster Universities Osteoarthritis Index. Secondary outcomes included pain, objective functional performance, anxiety, depression, exercise-related health beliefs and healthcare utilisation. All outcomes were assessed at baseline and 12 months after completing the interventions (primary endpoint). ANCOVA investigated between-group differences. Both groups demonstrated similar improvements in clinical outcomes. Outpatient physiotherapy cost pound 130 per person and the healthcare utilisation costs of participants over 1 year were pound 583. The ESCAPE-knee pain programme cost pound 64 per person and the healthcare utilisation costs of participants over 1 year were pound 320. ESCAPE-knee pain can be delivered as a community-based integrated rehabilitation programme for people with chronic knee pain. Both ESCAPE-knee pain and outpatient physiotherapy produced sustained physical and psychosocial benefits, but ESCAPE-knee pain cost less and was more cost-effective.

  9. Intensive lifestyle intervention improves physical function among obese adults with knee pain: findings from the Look AHEAD trial.

    PubMed

    Foy, Capri G; Lewis, Cora E; Hairston, Kristen G; Miller, Gary D; Lang, Wei; Jakicic, John M; Rejeski, W Jack; Ribisl, Paul M; Walkup, Michael P; Wagenknecht, Lynne E

    2011-01-01

    Lifestyle interventions have resulted in weight loss or improved physical fitness among individuals with obesity, which may lead to improved physical function. This prospective investigation involved participants in the Action for Health in Diabetes (Look AHEAD) trial who reported knee pain at baseline (n = 2,203). The purposes of this investigation were to determine whether an Intensive Lifestyle Intervention (ILI) condition resulted in improvement in self-reported physical function from baseline to 12 months vs. a Diabetes Support and Education (DSE) condition, and whether changes in weight or fitness mediated the effect of the ILI. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and physical function subscales, and WOMAC summary score. ILI participants exhibited greater adjusted mean weight loss (s.e.) vs. DSE participants (-9.02 kg (0.48) vs. -0.78 kg (0.49); P < 0.001)). ILI participants also demonstrated more favorable change in WOMAC summary scores vs. DSE participants (β (s.e.) = -1.81 (0.63); P = 0.004). Multiple regression mediation analyses revealed that weight loss was a mediator of the effect of the ILI intervention on change in WOMAC pain, function, and summary scores (P < 0.001). In separate analyses, increased fitness also mediated the effect of the ILI intervention upon WOMAC summary score (P < 0.001). The ILI condition resulted in significant improvement in physical function among overweight and obese adults with diabetes and knee pain. The ILI condition also resulted in significant weight loss and improved fitness, which are possible mechanisms through which the ILI condition improved physical function.

  10. Preliminary validation of 2 magnetic resonance image scoring systems for osteoarthritis of the hip according to the OMERACT filter.

    PubMed

    Maksymowych, Walter P; Cibere, Jolanda; Loeuille, Damien; Weber, Ulrich; Zubler, Veronika; Roemer, Frank W; Jaremko, Jacob L; Sayre, Eric C; Lambert, Robert G W

    2014-02-01

    Development of a validated magnetic resonance image (MRI) scoring system is essential in hip OA because radiographs are insensitive to change. We assessed the feasibility and reliability of 2 previously developed scoring methods: (1) the Hip Inflammation MRI Scoring System (HIMRISS) and (2) the Hip Osteoarthritis MRI Scoring System (HOAMS). Six readers (3 radiologists, 3 rheumatologists) participated in 2 reading exercises. In Reading Exercise 1, MRI of the hip of 20 subjects were read at a single time point followed by further standardization of methodology. In Reading Exercise 2, MRI of the hip of 18 subjects from a randomized controlled trial, assessed at 2 timepoints, and 27 subjects from a cross-sectional study were read for HIMRISS and HOAMS bone marrow lesions (BML) and synovitis. Reliability was assessed using intraclass correlation coefficient (ICC) and kappa statistics. Both methods were considered feasible. For Reading 1, HIMRISS ICC were 0.52, 0.61, 0.70, and 0.58 for femoral BML, acetabular BML, effusion, and total scores, respectively; and for HOAMS, summed BML and synovitis ICC were 0.52 and 0.46, respectively. For Reading 2, HIMRISS and HOAMS ICC for BML and synovitis-effusion improved substantially. Interobserver reliability for change scores was 0.81 and 0.71 for HIMRISS femoral and HOAMS summed BML, respectively. Responsiveness and discrimination was moderate to high for synovitis-effusion. Significant associations were noted between BML or synovitis scores and Western Ontario and McMaster Universities Osteoarthritis Index pain scores for baseline values (p ≤ 0.001). The BML and synovitis-effusion components of both HIMRISS and HOAMS scoring systems are feasible and reliable, and should be validated further.

  11. Influence of continuous positive airway pressure on outcomes of rehabilitation in stroke patients with obstructive sleep apnea.

    PubMed

    Ryan, Clodagh M; Bayley, Mark; Green, Robin; Murray, Brian J; Bradley, T Douglas

    2011-04-01

    In stroke patients, obstructive sleep apnea (OSA) is associated with poorer functional outcomes than in those without OSA. We hypothesized that treatment of OSA by continuous positive airway pressure (CPAP) in stroke patients would enhance motor, functional, and neurocognitive recovery. This was a randomized, open label, parallel group trial with blind assessment of outcomes performed in stroke patients with OSA in a stroke rehabilitation unit. Patients were assigned to standard rehabilitation alone (control group) or to CPAP (CPAP group). The primary outcomes were the Canadian Neurological scale, the 6-minute walk test distance, sustained attention response test, and the digit or spatial span-backward. Secondary outcomes included Epworth Sleepiness scale, Stanford Sleepiness scale, Functional Independence measure, Chedoke McMaster Stroke assessment, neurocognitive function, and Beck depression inventory. Tests were performed at baseline and 1 month later. Patients assigned to CPAP (n=22) experienced no adverse events. Regarding primary outcomes, compared to the control group (n=22), the CPAP group experienced improvement in stroke-related impairment (Canadian Neurological scale score, P<0.001) but not in 6-minute walk test distance, sustained attention response test, or digit or spatial span-backward. Regarding secondary outcomes, the CPAP group experienced improvements in the Epworth Sleepiness scale (P<0.001), motor component of the Functional Independence measure (P=0.05), Chedoke-McMaster Stroke assessment of upper and lower limb motor recovery test of the leg (P=0.001), and the affective component of depression (P=0.006), but not neurocognitive function. Treatment of OSA by CPAP in stroke patients undergoing rehabilitation improved functional and motor, but not neurocognitive outcomes. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00221065.

  12. A Randomized Controlled Trial of Acupuncture for Osteoarthritis of the Knee: Effects of Patient-Provider Communication

    PubMed Central

    Suarez-Almazor, Maria E.; Looney, Carol; Liu, YanFang; Cox, Vanessa; Pietz, Kenneth; Marcus, Donald M.; Street, Richard L.

    2012-01-01

    Objectives There is conflicting evidence on the efficacy of Traditional Chinese Acupuncture (TCA), and the role of placebo effects elicited by acupuncturists’ behavior has not been elucidated. We conducted a 3-month randomized clinical trial in patients with knee osteoarthritis to compare the efficacy of TCA to sham acupuncture, and examine the effects of acupuncturists’ communication style. Methods Acupuncturists were trained to interact in one of two communication styles: ‘high’ or ‘neutral’ expectations. Patients were randomized to one of 3 groups: waiting list, ‘high’ or ‘neutral’, and nested within style, TCA or sham acupuncture over 6 weeks. Sham acupuncture was performed in non-meridian points, with shallow needles and minimal stimulation. Primary outcome measures were: Joint-specific Multidimensional Assessment of Pain (J-MAP), Western Ontario McMaster Osteoarthritis Index (WOMAC), and satisfaction. Results 455 patients who received treatment (TCA or sham) and 72 controls were included. No statistically significant differences were observed between TCA or sham acupuncture, but both groups had significant reductions in J-MAP and WOMAC pain compared to the waiting group (-1.1, -1.0, and -0.1, p<0.001; -13.7, -14, -1.7, p<0.001). Statistically significant differences were observed in J-MAP pain reduction and satisfaction, favoring the ‘high’ expectations group. Fifty-two percent and 43% in the TCA and sham groups thought they had received TCA (kappa=0.05), suggesting successful blinding. Conclusion TCA was not superior to sham acupuncture. However, acupuncturists’ style had significant effects on pain reduction and satisfaction, suggesting that the analgesic benefits of acupuncture can be partially mediated through placebo effects related to the acupuncturist's behavior. PMID:20506122

  13. Pilot study of acupuncture for the treatment of joint symptoms related to adjuvant aromatase inhibitor therapy in postmenopausal breast cancer patients.

    PubMed

    Crew, Katherine D; Capodice, Jillian L; Greenlee, Heather; Apollo, Arlyn; Jacobson, Judith S; Raptis, George; Blozie, Kimberly; Sierra, Alex; Hershman, Dawn L

    2007-12-01

    Aromatase inhibitors (AIs) have become the standard of care for the adjuvant treatment of postmenopausal, hormone-sensitive breast cancer. However, patients receiving AIs may experience joint symptoms, which may lead to early discontinuation of this effective therapy. We hypothesize that acupuncture is a safe and effective treatment for AI-induced arthralgias. Postmenopausal women with early-stage breast cancer who had self-reported musculoskeletal pain related to adjuvant AI therapy were randomized in a crossover study to receive acupuncture twice weekly for 6 weeks followed by observation or vice-versa. The intervention included full body and auricular acupuncture, and a joint-specific point prescription. Outcome measures included the Brief Pain Inventory-Short Form (BPI-SF), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, the Functional Assessment of Cancer Therapy-General (FACT-G) quality of life measure, and serum levels of inflammatory markers, IL-1 beta and TNF-alpha. Twenty-one women were enrolled and two discontinued early. From baseline to the end of treatment, patients reported improvement in the mean BPI-SF worst pain scores (5.3 to 3.3, p = 0.01), pain severity (3.7 to 2.5, p = 0.02), and pain-related functional interference (3.1 to 1.7, p = 0.02), as well as the WOMAC function subscale and FACT-G physical well-being (p = 0.02 and 0.04, respectively). No adverse events were reported. In this pilot study, acupuncture reduced AI-related joint symptoms and improved functional ability and was well-tolerated. Musculoskeletal side effects are common among breast cancer survivors on adjuvant AI therapy, therefore, effective treatments are needed for symptom relief and to improve adherence to these life-saving medications.

  14. Full kinetic chain manual and manipulative therapy plus exercise compared with targeted manual and manipulative therapy plus exercise for symptomatic osteoarthritis of the hip: a randomized controlled trial.

    PubMed

    Brantingham, James W; Parkin-Smith, Gregory; Cassa, Tammy Kay; Globe, Gary A; Globe, Denise; Pollard, Henry; deLuca, Katie; Jensen, Muffit; Mayer, Stephan; Korporaal, Charmaine

    2012-02-01

    To determine the short-term effectiveness of full kinematic chain manual and manipulative therapy (MMT) plus exercise compared with targeted hip MMT plus exercise for symptomatic mild to moderate hip osteoarthritis (OA). Parallel-group randomized trial with 3-month follow-up. Two chiropractic outpatient teaching clinics. Convenience sample of eligible participants (N=111) with symptomatic hip OA were consented and randomly allocated to receive either the experimental or comparison treatment, respectively. Participants in the experimental group received full kinematic chain MMT plus exercise while those in the comparison group received targeted hip MMT plus exercise. Participants in both groups received 9 treatments over a 5-week period. Western Ontario and McMasters Osteoarthritis Index (WOMAC), Harris hip score (HHS), and Overall Therapy Effectiveness, alongside estimation of clinically meaningful outcomes. Total dropout was 9% (n=10) with 7% of total data missing, replaced using a multiple imputation method. No statistically significant differences were found between the 2 groups for any of the outcome measures (analysis of covariance, P=.45 and P=.79 for the WOMAC and HHS, respectively). There were no statistically significant differences in the primary or secondary outcome scores when comparing full kinematic chain MMT plus exercise with targeted hip MMT plus exercise for mild to moderate symptomatic hip OA. Consequently, the nonsignificant findings suggest that there would also be no clinically meaningful difference between the 2 groups. The results of this study provides guidance to musculoskeletal practitioners who regularly use MMT that the full kinematic chain approach does not appear to have any benefit over targeted treatment. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Hydrotherapy versus conventional land-based exercise for the management of patients with osteoarthritis of the knee: a randomized clinical trial.

    PubMed

    Silva, Luciana E; Valim, Valeria; Pessanha, Ana Paula C; Oliveira, Leda M; Myamoto, Samira; Jones, Anamaria; Natour, Jamil

    2008-01-01

    This study was designed to evaluate the effectiveness of hydrotherapy in subjects with osteoarthritis (OA) of the knee compared with subjects with OA of the knee who performed land-based exercises. Sixty-four subjects with OA of the knee were randomly assigned to 1 of 2 groups that performed exercises for 18 weeks: a water-based exercise group and a land-based exercise group. The outcome measures included a visual analog scale (VAS) for pain in the previous week, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain during gait assessed by a VAS at rest and immediately following a 50-foot (15.24-m) walk test (50FWT), walking time measured at fast and comfortable paces during the 50FWT, and the Lequesne Index. Measurements were recorded by a blinded investigator at baseline and at 9 and 18 weeks after initiating the intervention. The 2 groups were homogenous regarding all parameters at baseline. Reductions in pain and improvements in WOMAC and Lequesne index scores were similar between groups. Pain before and after the 50FWT decreased significantly over time in both groups. However, the water-based exercise group experienced a significantly greater decrease in pain than the land-based exercise group before and after the 50FWT at the week-18 follow-up. Both water-based and land-based exercises reduced knee pain and increased knee function in participants with OA of the knee. Hydrotherapy was superior to land-based exercise in relieving pain before and after walking during the last follow-up. Water-based exercises are a suitable and effective alternative for the management of OA of the knee.

  16. Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes.

    PubMed

    Fransen, Marlene; Nairn, Lillias; Winstanley, Julie; Lam, Paul; Edmonds, John

    2007-04-15

    To determine whether Tai Chi or hydrotherapy classes for individuals with chronic symptomatic hip or knee osteoarthritis (OA) result in measurable clinical benefits. A randomized controlled trial was conducted among 152 older persons with chronic symptomatic hip or knee OA. Participants were randomly allocated for 12 weeks to hydrotherapy classes (n = 55), Tai Chi classes (n = 56), or a waiting list control group (n = 41). Outcomes were assessed 12 and 24 weeks after randomization and included pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index), general health status (Medical Outcomes Study Short Form 12 Health Survey [SF-12], version 2), psychological well-being, and physical performance (Up and Go test, 50-foot walk time, timed stair climb). At 12 weeks, compared with controls, participants allocated to hydrotherapy classes demonstrated mean improvements (95% confidence interval) of 6.5 (0.4, 12.7) and 10.5 (3.6, 14.5) for pain and physical function scores (range 0-100), respectively, whereas participants allocated to Tai Chi classes demonstrated improvements of 5.2 (-0.8, 11.1) and 9.7 (2.8, 16.7), respectively. Both class allocations achieved significant improvements in the SF-12 physical component summary score, but only allocation to hydrotherapy achieved significant improvements in the physical performance measures. All significant improvements were sustained at 24 weeks. In this almost exclusively white sample, class attendance was higher for hydrotherapy, with 81% attending at least half of the available 24 classes, compared with 61% for Tai Chi. Access to either hydrotherapy or Tai Chi classes can provide large and sustained improvements in physical function for many older, sedentary individuals with chronic hip or knee OA.

  17. The effectiveness of hydrotherapy in the treatment of social and behavioral aspects of children with autism spectrum disorders: a systematic review.

    PubMed

    Mortimer, Rachel; Privopoulos, Melinda; Kumar, Saravana

    2014-01-01

    Autism spectrum disorders (ASDs) are increasing in prevalence. Children with ASDs present with impairments in social interactions; communication; restricted, repetitive, and stereotyped patterns of behavior, interests, or activities; as well as motor delays. Hydrotherapy is used as a treatment for children with disabilities and motor delays. There have been no systematic reviews conducted on the effectiveness of hydrotherapy in children with ASDs. We aimed to examine the effectiveness of hydrotherapy on social interactions and behaviors in the treatment of children with ASDs. A systematic search of Cochrane, CINAHL, PsycINFO, Embase, MEDLINE®, and Academic Search Premier was conducted. Studies of participants, aged 3-18 years, with ASDs at a high-functioning level were included if they utilized outcome measures assessing social interactions and behaviors through questionnaire or observation. A critical appraisal, using the McMaster Critical Review Form for Quantitative Studies, was performed to assess methodological quality. Four studies of varying research design and quality met the inclusion criteria. The participants in these studies were aged between 3-12 years of age. The duration of the intervention ranged from 10-14 weeks, and each study used varied measures of outcome. Overall, all the studies showed some improvements in social interactions or behaviors following a Halliwick-based hydrotherapy intervention. Few studies have investigated the effect of hydrotherapy on the social interactions and behaviors of children with ASDs. While there is an increasing body of evidence for hydrotherapy for children with ASDs, this is constrained by small sample size, lack of comparator, crude sampling methods, and the lack of standardized outcome measures. Hydrotherapy shows potential as a treatment method for social interactions and behaviors in children with ASDs.

  18. Scale invariance and longitudinal stability of the Physical Functioning Western Ontario and MacMaster Universities Osteoarthritis Index using the Rasch model.

    PubMed

    Ayala, Alba; Bilbao, Amaia; Garcia-Perez, Sonia; Escobar, Antonio; Forjaz, Maria João

    2018-03-01

    The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) measures the quality of life of patients with osteoarthritis (OA), and there is a specific scale for the physical functioning dimension, the short version with seven items WOMAC-pf. This study describes the application of the Rasch model to explore scale invariance and response stability of the WOMAC-pf short version across affected joint and over time. A sample of 884 patients with OA, from 15 hospitals in Spain, completed the WOMAC-pf before surgery (baseline) and at 3, 6 and 12 months post-surgery of hip or knee. The invariance by joint was explored through the differential item functioning (DIF) analysis of the Rasch model using baseline data, and time stability (DIF by time) were evaluated in stack data (each participant is represented four times, one by time point). Mean age of the patients was of 69.13 years (SD 10.01), 59.3% of them were women (n = 524), 59.2% had knee OA (n = 523) and 40.8% hip OA (n = 361). Item "putting on socks" showed DIF by joint and time. Fit to the Rasch model using stack data improved when this item was removed. Good reliability for individual use, local independency and unidimensionality of the models were confirmed. WOMAC-pf 7-item short version was invariant over time and joint when item "putting on socks" was removed. Researchers should carefully evaluate this item as it presents problems in scale invariance and stability, which could affect results when comparing data by joint or when computing change scores.

  19. Compliance of medical students with voluntary use of personal data assistants for clerkship assessments.

    PubMed

    Norman, Geoffrey; Keane, David; Oppenheimer, Lawrence

    2008-01-01

    For several years, final-year students at McMaster University have been required to complete 10 mini-CEX type assessments per rotation. A similar system was being introduced at Ottawa. To facilitate data capture, we decided to introduce a personal data assistant (PDA)-based system and evaluate its impact. A randomized trial was designed to compare the acceptability of PDA and printed evaluation forms. The trial failed because of clerks' unwillingness to use PDAs. A focus group was held and user surveys were administered, chiefly by e-mail, to explore students' preference for printed forms. Thirty percent of invited clerks (52/176) agreed to use a PDA; 6% (11; 21% of those agreeing) recorded one or more encounters; 2% (4) recorded at least the minimum number of evaluations required by their program. Most survey respondents expressed concerns related primarily to the relative inconvenience of PDAs compared to paper, a judgment reflecting the time required both to install required software and to become familiar with the software and data entry form, and to record information via the form. A minority were also concerned about assessors' willingness or ability to use PDA forms. Before asking students and clinical supervisors to use a PDA-based encounter-evaluation form in clerkship, planners should conduct a careful assessment of the advantages and disadvantages for students of the system they hope to implement. The prima facie greater convenience and efficiency of the PDA may actually be offset by workplace disincentives and inefficiencies in data recording, relative to the incentives and efficiencies associated with a system based on printed (paper) forms.

  20. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Macann, Andrew, E-mail: amacann@adhb.govt.nz; Fua, Tsien; Milross, Chris G.

    Purpose: To assess the impact of domicile-based humidification on symptom burden during radiation therapy (RT) for head-and-neck (H and N) cancer. Methods and Materials: From June 2007 through June 2011, 210 patients with H and N cancer receiving RT were randomized to either a control arm or to receive humidification using the Fisher and Paykel Healthcare MR880 humidifier. Humidification commenced on day 1 of RT and continued until Common Terminology Criteria for Adverse Events (CTCAE), version 3.0, clinical mucositis (CMuc) grade ≤1 occurred. Forty-three patients (42%) met a defined benchmark for humidification compliance and contributed to per protocol (PP) analysis.more » Acute toxicities, hospitalizations, and feeding tube events were recorded prospectively. The McMaster University Head and Neck Radiotherapy Questionnaire (HNRQ) was used for patient-reported outcomes. The primary endpoint was area under the curve (AUC) for CMuc grade ≥2. Results: There were no significant differences in AUC for CMuc ≥2 between the 2 arms. Humidification patients had significantly fewer days in hospital (P=.017). In compliant PP patients, the AUC for CTCAE functional mucositis score (FMuc) ≥2 was significantly reduced (P=.009), and the proportion who never required a feeding tube was significantly greater (P=.04). HNRQ PP analysis estimates also in the direction favoring humidification with less symptom severity, although differences at most time points did not reach significance. Conclusions: TROG 07.03 has provided efficacy signals consistent with a role for humidification in reducing symptom burden from mucositis, but the influence of humidification compliance on the results moderates recommendations regarding its practical utility.« less